经皮冠状动脉介入术中静脉应用盐酸艾司洛尔对急性ST段抬高型心肌梗死患者临床疗效及安全性

Clinical Efficacy and Safety of Intravenous Esmolol Hydrochloride During Percutaneous Coronary Intervention in Patients with Acute ST-segment Elevation Myocardial Infarction

目的为了增加急性ST段抬高型心肌梗死患者经皮冠状动脉介入术治疗效果,探讨术中静脉应用盐酸艾司洛尔治疗的价值和意义。方法按患者住院号先后顺序在医院2018年10月—2019年10月经皮冠状动脉介入术治疗的急性ST段抬高型心肌梗死患者中抽取100例作为研究对象,借助计算机随机分组软件将其平均分组,所有患者均同时予以常规综合治疗(抗血小板聚集、抗凝、改善心肌供血、降脂及营养心肌等),而观察组患者则同时予以盐酸艾司洛尔治疗,对比两组治疗前后在心肌酶、不良反应等方面的差异。结果用药前观察组与对照组患者的心肌酶(CK-MB、c TnI)水平比较差异无统计学意义(P>0.05);治疗后两组患者的CK-MB、c TnI水平较治疗前均有降低,同时两组间对比观察组降低更显著,组间比较差异有统计学意义(P<0.05);观察组患者用药半年后不良心血管事件发生率10.00%与对照组12.00%,比较差异无统计学意义(χ^2=0.100,P>0.05)。结论经皮冠状动脉介入术治疗的急性ST段抬高型心肌梗死患者术中静滴盐酸艾司洛尔治疗,在改善患者心功能的同时未增加药物不良反应,安全性高。

Objective In order to increase the therapeutic effect of percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction, to explore the value and significance of intraoperative intravenous esmolol hydrochloride treatment. Methods According to the order of hospitalization number, 100 patients with acute ST-segment elevation myocardial infarction treated by percutaneous coronary intervention in the hospital from October2018 to October 2019 were selected as the research object, and they were selected by computer randomization software.All patients were equally divided into groups. All patients were treated with conventional comprehensive treatment(anti-platelet aggregation, anticoagulation, improvement of myocardial blood supply, lipid-lowering, nourishing myocardium, etc.), while patients in the observation group were treated with esmolol hydrochloride at the same time.Differences in myocardial enzymes and adverse reactions were compared. Results In this study, there was no statistically significant difference in the levels of myocardial enzymes(CK-MB, c TnI) between the observation group and the control group before treatment(P >0.05);the CK-MB, c TnI levels of the two groups of patients were not statistically significant after treatment. The level of c TnI was lower than before treatment, and the decrease was more significant between the two groups compared to the observation group, and the difference between the groups was statistically significant(P<0.05);the incidence of adverse cardiovascular events in the observation group was 10.00%after half a year of medication compared with the control group 12.00%, which was not statistically significant difference(χ^2=0.100,P >0.05). Conclusion Intravenous infusion of esmolol hydrochloride in patients with acute ST-segment elevation myocardial infarction treated by percutaneous coronary intervention can improve the heart function of the patients without increasing the side effects of the drug.