滴定表在ST段抬高型心肌梗死患者应用美托洛尔中的价值

Titration of Beta-blockers in patients with ST-elevation myocardial infarction

目的:探讨使用滴定表能否提高ST段抬高型心肌梗死(STEMI)患者院内美托洛尔剂量。方法:纳入STEMI患者100例,随机分配至滴定组(50例)与对照组(50例),比较两组患者入院24h内美托洛尔治疗率及出院前美托洛尔剂量的差异,观察6个月内主要心血管不良事件(MACE)发生率。结果:24h内美托洛尔治疗率无统计学差异(84%︰82%)。滴定组出院前高剂量组(30例)占比高于对照组(8例)(60%︰16%,P=0.000),滴定组目标剂量组(6例)占比高于对照组(12%︰0%,P=0.027)。滴定组6个月内MACE发生率较对照组低,但无统计学差异(2%︰8%,P=0.362)。结论:滴定表的使用可以提高STEMI患者院内美托洛尔剂量,可能进一步改善STEMI患者的预后。

Objective：To determine the effectiveness ofβ-blockers titration table in improving the maximal doses of theβ-adrenergic receptor blocking agents in STEMI during hospitalization.Method：A total of 100 STEMI patients were included and randomized into titration group（n=50）and control group（n=50）.The rate of metoprolol treatment within the first 24 hours of admission,the proportion of patients reaching the high dose and target dose of metoprolol before discharge,and the incidence of MACE at 6months were observed.Result：There was no difference between titration and control groups in metoprolol use within the first 24 hours of admission（84% vs.82%,P=0.790）.There were 30patients（60%）reached maximum dose and 6patients（12%）reached target dose of metoprolol in titration group,while 8patients（16%）reached maximum dose and 0patient reached target dose before discharge（all P0.05）.The incidence of MACE during 6months follow-up was no obvious difference intration and control group（2% vs.8%,P=0.362）.Conclusion：Titration table ofβ-blockers improvesβ-blockers treatment in STEMI patients through increasing the proportion of patients reaching maximal or target doses,which may lead to an improvement in outcomes for STEMI patients.