爱司洛尔在心血管疾病急症治疗中的临床应用(摘要)

Clinical application of esmolo in cardiovascular emergency conditions

目的 评价爱司洛尔在心血管疾病急症治疗中应用的安全性和疗效。方法 2 2 5例心血管急症患者 ,其中CABG术后及普通外科术后房扑 房颤分别为 60例及 10 0例 ;不稳定性心绞痛及急性心肌梗死分别为 5 0例及15例。爱司洛尔静脉负荷量 0 .5mg kg,l分钟内静注 ,继以 0 .0 5mg kg min ,持续静脉输注 ,若无效 ,4分钟后静脉负荷量不变 ,维持量递增 ,直至 0 .2mg kg min。结果 CABG术后及外科术后房扑 房颤 2 4小时内的转复率分别为 75 %及83 %。房扑 房颤的快速心室率由用药前 198± 2 7 分下降至 12 9± 16 分 (p <0 .0 5 )。心绞痛和急性心肌梗死患者用药后平均心率由用药前 10 1± 13 (79-12 3 ) 分下降至 77± 14 分 (p <0 .0 5 ) ;平均血压由 12 6± 19 71± 12mmHg下降至10 7± 2 0 62± 8mmHg (p <0 .0 5 )。 3 7恶化劳力性心绞痛的缓解率为 79%。所有患者均未出现严重不良反应。结论 爱司洛尔是用于心血管急症治疗的一种用法安全、疗效确切的较为理想的药物。

Objective: Evaluate the safety and efficacy of esmolol in emergency cases of cardiovascular diseases. Methods: Of 225 cases enrolled AF/Af after CABG or general operations were 60 and 100respectively; unstable angina(UA) and acute myocardial infarction(AMI) were 50 and 15 separately. Esmolol was given as bolus 0.5mg/Kg followed by continuous intravenous infusion at 0.05mg/Kg/min and can be titrated to 0.2 mg/Kg/min without increase of bolus. Results: Rapid Ventricular rate decreased from 198±27/min to 129±16/mmin (p<0.05). Conversion: to sinus rhythm were 75%(CABG) and 83% (other operations) within 24th. As for UA and AMI esmolol decreased heart rate from 101±13 (79-123) /min to 77±14/min (p<0.05); BP from 126±19/71±12 mmHg to 107±20/62±8mmHg (p<0.05). Relief rate of exacerbated angina was 79%. No severe side effects occurred. Conclusion: esmolol is ansafe and effective medication ideally used in cardiovascular emergency conditions.