美托洛尔对急性心肌梗死QT离散度及恶性心律失常的影响

Influence of metoprolol on QTcd and malignant ventricular arrhythmia in acute myocardial infarction

目的 探讨美托洛尔对急性心肌梗死(AMI)后QT间期离散度(QTcd)及恶性心律失常(MVA)事件的影响。方法 将88例分为美托洛尔组(46例)及对照组(42例)。美托洛尔组在常规治疗基础上给予美托洛尔6.24-12.50mg,2次/d,以后根据病情渐加量到25-50mg,2次/d;对照组仅常规治疗,分别测定入院后第1天、第7天及0.5年、1年时24h动态心电图及12导联心电图,常规进行QTcd分析,并同时观察各阶段MVA发生率。结果 1周内两组QTcd及MVA变化无显著性差异,但美托洛尔组MVA事件有减少趋势,0.5年后美托洛尔组QTcd显著改善(P<0.01),MVA事件发生率明显低于对照组(P<0.01)。结论 美托洛尔能有效改善AMI后患者QTcd,降低MVA发生率,但此种改变在长时间治疗后明显。

Objective To probe the effect of metoprolol on QT interval dispersion (QTcd) and malignant ventricular arrhythmia (MVA) in acute myocardial infarction. Method Eighty eight patients with acute myocardial infarction were random divided into 2 groups: metoprolol group(n=46) and control group (n=42). The metoprolol group was given metoprolol 12.5-50mg twice a day. Then the QTcd and MVA events in each period (1day, 7days, 6months and 1year after admitted hospital) in two groups were measured and compared. Result The QTcd and MVA events were of no significant changes in both groups within one week. After six months, the MVA events were remarkably decreased in metoprolol group (P<0.01). Conclusion Metoprolol may improve the QTcd and reduce the MVA events in acute myocardial infarction.