酒石酸美托洛尔对交感风暴合并心源性休克治疗的临床效果

Effect of Metoprolol tartrate for the treatment of sympathetic electrical storm combine with cardiogenic shock

目的观察酒石酸美托洛尔对交感风暴并心源性休克治疗的临床治疗效果。方法选取2010年1月~2014年1月来我院就诊的交感风暴合并心源性休克患者80例,随机分为给药组和药物干预组,每组各40例。给药组采用静脉注射胺碘酮及电复律等常规治疗;药物干预组在常规治疗的基础上给予酒石酸美托洛尔缓慢静脉注射,首剂5 mg缓慢静脉注射（1 mg/min）,3 min后重复上述剂量2~3次,总剂量不超过15 mg。观察两组患者终止室性心动过速/心室颤动电复律次数、终止有效率及1周内死亡率,以及出现三度房室传导阻滞（AVBⅢ）、血压下降等的情况。结果药物干预组与给药组电复律次数及1周内的死亡率比较,组间差异有统计学意义（P〈0.05）,同时药物干预组终止室速及室颤的有效率明显高于给药组,组间差异有统计学意义（P〈0.05）;在安全性上,两组AVBⅢ发生率、血压下降情况比较,差异无统计学意义（P〉0.05）。结论酒石酸美托洛尔治疗交感风暴并心源性休克安全有效。

Objective To explore the clinical efficacy of Metoprolol tartrate on the sympathetic electrical storm combine with cardiogenic shock. Methods From January 2010 to January 2014,80 patients suffering from sympathetic electrical storm combine with cardiogenic shock were selected from our hospital.Patients were randomly divided into treatment group（n=20） and control group（n=20）.The patients in control group were given intravenous administration amiodarone combine with electrical cardioversion,and patients in the treatment group were given further treatment of intravenous administration Metoprolol tartrate（1 mg/min）,the first dosage was 5 mg and repeat this dose for 2-3 times after observation 3 minutes.The total dose was no more than 15 mg.The number of termination of ventricular tachycardia/ventricular fibrillation,cardioerter number,termination of the efficient,mortality in a week and drop of blood pressure in a third degree atrioventricular block（AVB Ⅲ） were observed. Results On the clinical efficacy,the number of electrical cardioversion and mortality in a week had significantly differences between two groups（P0.05）.The effective rate of termination of ventricular tachycardia/ventricular fibrillation in the treatment group was significantly higher than the control group,and the difference was statistically significant（P0.05）.On the security,there were no significant differences between two groups on the incidence of AVB Ⅲ and drop of blood pressure（P0.05）. Conclusion Metoprolol tartrate is effective in treatment of sympathetic electrical storm combine with cardiogenic shock.