摘要
目的评价酒石酸美托洛尔对接受非心脏手术的冠心病及高危因素患者围术期心脏事件的影响。方法102例择期非心脏手术患者，有明确冠心病或高危因素，随机分为2组，A组为对照组（n=51），B组为酒石酸美托洛尔组（n：51），从术前2h一直到术后30d，口服或静注酒石酸美托洛尔，根据血压、心率来调整剂量；记录围术期心率变化、肌酸激酶同功酶（CK-MB）水平、围术期不稳定心绞痛、心肌梗死、死亡以及脑卒中例数。结果酒石酸美托洛尔组术中、术后心率显著低于对照组（P〈0．05）。两组各有1例心肌梗死发生，对照组有1例死亡，2例脑梗死，对照组发生伴有sT段压低的不稳定心绞痛5（9．8％）例，酒石酸美托洛尔组1（2．0％）例，术后至少1件心血管事件对照组有15例，酒石酸美托洛尔组13例（P〉0．05）。结论酒石酸美托洛尔可能降低冠心病及高危因素患者非心脏手术后严重心血管不良事件发生率。
Objective To assess the effects of metoprolol on perioperative cardiovascular events in patients with risk or at high risk for coronary artery disease （ CAD ） who were to undergo non-cardiac surgery. Methods 102 patients with definite CAD or at high risk for CAD who were to undergo selective non-cardiac surgery were randomized to 2 equal groups： Group A （blank control group） and Group B given metoprolol orally or intravenously from 2 h before surgery to 30 days after surgery. The dosage of metoprolol was adjusted according to the blood pressure and heart rate. The changes of peri-operative heart rate （ HR）, level of creatine kinase （CK） -MB, cardiac events such as unstable angina pectoris （UAP） and myocardial infarction （ MI）, death, and stroke were recorded. Results The HR values, intra-operative and 6 h, 1 d, and 2 d after operation of Group B were all significantly lower than those of Group A （ all P 〈 0.05 ）. One patient from each group had MI. One case of death and two cases of strokes occurred in Group A. The occurrence rate of at least one cardiovascular event were 9.8% in Group A （5/51） and 2.0% in Group B （1/51） without significant difference between these 2 groups （P 〉 0. 05 ）. Conclusions Metoprolol reduces the incidence of postoperative severe cardiovascular episodes in patients with risk of or at high risk for CAD undergoing non-cardiac surgery.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第21期1476-1480,共5页
National Medical Journal of China
关键词
冠状动脉疾病
外科手术
心肌梗死
酒石酸美托洛尔
Coronary disease
Surgery procedures, operative
Myocardial infarction
Betaloc
