β受体阻滞剂对急性心肌梗死早期血钾影响观察

Effect of β blockers on serum potassium concentrations in acute myocardial infarction

目的 探讨不同的 β受体阻滞剂对急性心肌梗死 (AMI)早期血清钾浓度的变化的影响。 方法 10 6例发病后12h内入院的AMI病人 (按服用β受体阻滞剂分组 )和 5 0例稳定性心绞痛病人作对照组 ,静脉血查血清钾、血糖、肌酐 ,并行心电监护记录心率、心律。结果 (1)单纯AMI组病人与对照组、卡维地洛组、β1 受体阻滞剂组相比 ,血清钾浓度有显著差异 (P <0 .0 1或P <0 .0 5 ) ;卡维地洛组与 β1 受体阻滞剂组相比血清钾较高 (P <0 .0 5 ) ,与对照组之间差异无统计学意义。 (2 )各组之间血肌酐差异无显著性。 (3)直线相关分析 ,AMI组血钾与血糖、心率呈显著负相关 ,前者r=- 0 .14 (P =0 .0 4 ) ,后者r=- 0 .19(P =0 .0 1) ,其他各组相关系数r均无统计学意义。结论 新一代 β受体阻滞剂卡维地洛有较好地防止AMI早期血钾降低的作用。

Objective To detect serum potassium concentrations in different groups of β blockers in the early stage of acute myocardial infarction (AMI). Method 106 patients with AMI were divided into 3 groups according to different β blockers usages, compared with 50 patients with stable angina pectoris . Serum potassium and glucose were measured. Results Compared with other groups, serum potassium in β-1 blocker-free group was significantly reduced. Pretreatment with carvedilol had highly significant impact on potassium( P <0.01) whilst pretreatment with other selective β-1 blockers had significant impact( P <0.05).There were significant negative correlations between serum potassium concentrations and markers of stress in the AMI group : blood sugar( r = -0.14 , P =0.04),heart rate( r =-0.19, P =0.01). Conclusion β blockers carvedilol might prevent occurrence of low serum potassium in AMI patients of early-stage.