摘要
目的探讨比索洛尔与美托洛尔治疗经皮冠状动脉介入术(primary percutaneous coronary intervention,PCI)后急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)的疗效。方法选取90例行PCI后的STEMI患者,随机分为比索洛尔组和美托洛尔组,每组45例,术后分别给予比索洛尔与美托洛尔治疗,比较2组心率变化、心率变异性(heart rate variability,HRV)时域指标、心功能、冠脉血流速度、心肌损伤指标、血清高迁移率族蛋白B1(high mobility group protein 1,HMGB1)及可溶性骨髓细胞样转录因子1(solubl triggering receptor expressed on myeloid cells-like transcript 1,sTLT-1)水平的变化。结果治疗后,比索洛尔组最慢心率、平均心率及最快心率低于美托洛尔组(P<0.05);比索洛尔组全部窦性心搏RR间期标准差(standard diviation of NN intervals,SDNN)、RR间期平均值标准差(standard deviation of all 5-minute RR intervals,SDANN)、相邻RR间期差值均方根(root mean square of successive R-R interval differences,RMSSD)及相邻RR间期之差>50 ms的数量占总窦性心搏数量的百分比(percent of NN50 in the total number of NN intervals,PNN50%)高于美托洛尔组(P<0.05);比索洛尔组治疗后左心室收缩末期容积(left ventricular end-systolic volume,LVESV)、舒张末期容积(left ventricular end-diastolic volume,LVEDV)低于美托洛尔组,左室射血分数(left ventricular ejection fraction,LVEF)、舒张早期与晚期流速比(Peak E/A,E/A)高于美托洛尔组(P<0.05);比索洛尔组冠脉血流速度储备(coronary flow velocity reserve,CFVR)、收缩期血流峰值速度(peak systolic velocity,PSV)高于美托洛尔组,校正TIMI帧计数(corrected TIMI frame count,CTFC)低于美托洛尔组(P<0.05);比索洛尔组血清B型脑钠肽(brain natriuretic peptide,BNP)、肌钙蛋白T(cardiac troponin T,cTnT)水平低于美托洛尔组(P<0.05);比索洛尔组血清HMGB1、sTLT1水平低于美托洛尔组(P<0.05);2组不良反应率比较差异�
Objective To explore the curative effect of bisoprolol and metoprolol on acute ST-segment elevation myocardial infarction(STEMI)after primary percutaneous coronary intervention(PCI).Methods A total of 90 patients with STEMI after PCI were enrolled and randomly divided into bisoprolol group and metoprolol group,45 cases in each group.The changes in heart rate,the time domain indexes of heart rate variability(HRV),cardiac function,coronary flow velocity,myocardial injury indexes,serum high mobility group protein 1(HMGB1)and soluble triggering receptor expressed on myeloid cells-like transcript 1(sTLT-1)were compared between the 2 groups.Results After treatment,the slowest heart rate,average heart rate and the fastest heart rate in bisoprolol group were lower than those in metoprolol group(P<0.05).The standard deviation of NN intervals(SDNN),standard deviation of all 5-minute RR intervals(SDANN),root mean square of successive R-R interval differences(RMSSD)and percent of NN50 in the total number of NN intervals(PNN 50%)in bisoprolol group were higher than those in metoprolol group(P<0.05).After treatment,the left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)in bisoprolol group were lower than those in metoprolol group,while the left ventricular ejection fraction(LVEF)and peak E/A(E/A)were higher than those in metoprolol group(P<0.05).After treatment,the coronary flow velocity reserve(CFVR)and peak systolic velocity(PSV)in bisoprolol group were higher than those in metoprolol group,while the corrected TIMI frame count(CTFC)was lower than that in metoprolol group(P<0.05).After treatment,the levels of brain natriuretic peptide(BNP)and cardiac troponin T(cTnT)in bisoprolol group were lower than those in metoprolol group(P<0.05),and the levels of serum HMGB1 and sTLT-1 were lower than those in metoprolol group(P<0.05).The difference in the incidence of adverse reactions between the 2 groups was not statistically significant.Conclusion Bisoprolol can effectively reduce heart rate,i
作者
孙怀梅
刘翠萍
刘粉红
程忠强
SUN Huaimei;LIU Cuiping;LIU Fenhong;CHENG Zhongqiang(Department of Emergency,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China;Department of Neurology,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China;Department of Otolaryngology&Head and Neck Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《西北药学杂志》
CAS
2023年第5期160-165,共6页
Northwest Pharmaceutical Journal
基金
安徽省教学研究项目(编号:2020jyxm1206)。
关键词
比索洛尔
美托洛尔
急性ST段抬高型心肌梗死
经皮冠状动脉介入术
bisoprolol
metoprolol
acute ST-segment elevation myocardial infarction
primary percutaneous coronary intervention
