艾司洛尔在中青年急性前壁心肌梗死患者中的早期应用疗效分析

目的:探讨艾司洛尔对中青年急性前壁心肌梗死患者早期应用的临床效果。方法:纳入2008年1月至2020年8月苏州大学附属第二医院心血管内科收治的急性前壁心肌梗死患者，根据患者临床用药，分为美托洛尔组189例（治疗过程中β受体阻滞剂仅给予酒石酸美托洛尔缓释片）和艾司洛尔组104例（先给予艾司洛尔静脉注射，后给予酒石酸美托洛尔缓释片口服）。比较两组入院时及治疗后临床指标、Gensini评分和Killip分级、治疗情况以及治疗后7 d和治疗后3个月的心功能。结果:艾司洛尔组的甘油三酯（triglyceride，TG）明显高于美托洛尔组（ P<0.05），艾司洛尔组丙氨酸氨基转移酶（alanine aminotransferase，ALT）、天门冬氨酸氨基转移酶（aspartate aminotransferase，AST）明显低于美托洛尔组，两组间差异有统计学意义（ P<0.05）。艾司洛尔组的C-反应蛋白（C-reactive protein，CRP）、N-末端脑钠肽前体（N-terminal pro-brain natriuretic peptide，NT-proBNP）和罪犯血管Gensini评分低于美托洛尔组（ P<0.05），治疗7 d两组患者的心功能差异无统计学意义（ P>0.05）。治疗3个月后复查的左室射血分数（left ventricular ejection fraction，LVEF）艾司洛尔组高于美托洛尔组，而左室舒张末期内径（left ventricular end diastolic diameter，LVDD）艾司洛尔组低于美托洛尔组（ P<0.05）。艾司洛尔组的术后发作室速、休克和死亡例数少于美托洛尔组，但差异无统计学意义（ P>0.05）。 结论:中青年急性前壁心肌梗死患者经评估后应用艾司洛尔静脉泵入，对患者的心肌损伤、肝功能以及心功能有改善作用。

Early application of esmolol in young and middle-aged patients with acute anterior myocardial infarction

Objective:To investigate the clinical effect of esmolol on young and middle-aged patients with acute anterior myocardial infarction.Methods:Patients with acute anterior myocardial infarction from January 2008 to August 2020 were collected to obtain the basic information and clinical indicators. According to the clinical medication, the patients were divided into metoprolol group and esmolol group. The metoprolol group ( n=189) received routine esmolol, and the esmolol group ( n=104) received esmolol, intravenous injection, and then metoprolol sustained-release tablets. The clinical indexes, Gensini score, Killip grade, esmolol status and cardiac function after 7 d and 3 months of treatment were compared between the two groups. Results:Compared with the metoprolol group, the triglyceride (TG) was significantly higher, and the alanine aminotransferase (ALT) and aspartate aminotransferase (AST were significantly lower in the esmolol group (all P<0.05). The C-reactive protein (CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and Gensini scores of culprit vessels in the esmolol group were lower than those in the metoprolol group ( P<0.05). There was no significant difference in cardiac function between the two groups within 7 d after treatment ( P>0.05). After 3 months of treatment, the left ventricular ejection fraction (LVEF) was higher and left ventricular end diastolic diameter (LVDD) was lower than those in the metoprolol group ( P<0.05). The number of postperative, ventricular tachycardia, shock and death in the esmolol group were lower than those in the metoprolol group, but the difference was not statistically significant ( P>0.05). Conclusions:Intravenous infusion of esmolol in young and middle-aged patients with acute anterior myocardial infarction can significantly improve the myocardial injury, liver function and cardiac function in prognosis.