标题：艾司洛尔治疗冠心病心肌缺血的疗效观察

      作者：卢国良，魏 玲，杨晓华，王 莲，张筱军，尹 娜
    (成都军区昆明总医院地干病房，云南 昆明 650032）

      卷次： 2012年23卷10期

      【摘要】 目的 比较冠心病(CHD)患者冠状动脉不同病变程度与发生心肌缺血的关系，探讨超短效β阻滞剂
艾司洛尔缓解冠心病心肌缺血的效果。方法 利用冠状动脉造影确定(CHD患者)冠脉病变支数和狭窄程度；应
用动态心电图(DCG)记录，分析不同程度冠脉病变CHD患者心肌缺血的发作阵次、持续时间、ST段下移幅度和
发作时心率；对心肌缺血患者常规使用硝酸酯、吗啡等药物后未能完全缓解者，给予盐酸艾司洛尔注射液，以用药
前和用药后4 h作为评价时间点，评价指标主要包括症状评分、心电图ST段压低、心率和血压。结果 163例中有
126例出现缺血性ST段改变，在不同程度冠脉病变支数和狭窄程度间比较差异有统计学意义(P<0.05或P<0.01)；
采用艾司洛尔治疗的103例患者中有86例有效，治疗有效率为83.5%，其中，59例显效患者用药(68±21) min后症状
完全缓解(P<0.01)，心率和血压均显著下降(P<0.01)，心电图ST段基本恢复至基线(P<0.01)。结论 冠脉病变支
数、狭窄程度与心肌缺血的发生率有关；艾司洛尔可迅速、安全、有效缓解冠脉病变所致心肌缺血。

      【关键词】 艾司洛尔；冠心病；心肌缺血

      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350(2012)10—009—03<

br>Clinial efficacy of esmolol on myocardial ischemia induced by coronary artery disease.
LU Guo-liang, WEI Ling,
YANG Xiao-hua, WANG Lian, ZHANG Xiao-jun, YIN Na. Ward of Local Cadres, Kunming General Hospital of Chengdu
Military Region, Kunming 650032, Yunnan, CHINA

【Abstract】 Objective To investigate the relationship between different degrees of coronary and myocardial
ischemia in patients with coronary heart disease (CHD), and the effect of esmolol in the treatment of myocardial isch-
emia caused by coronary artery disease. Methods Coronary lesion counts and stenosis degree were determined using
coronary angiography. Array onset times, duration, ST segment depression and heart rate of myocardial ischemia in
CHD patients induced by different coronary artery disease degrees were analyzed using dynamic electrocardiogram
(DCG) records. Patients with myocardial ischemia with no improvements by routine treatment of intravenous nitrate
or even morphine, were then given esmolol hydrochloride injection. Symptom score, ST-segment depression, heart
rate and blood pressure were evaluated before treatment and four hours after treatment. Results Of the 163 patients,
126 had ischemic ST segment change, and patients showed statistically significant difference in coronary lesion counts
and stenosis degree (P<0.05 or P<0.01); Among the 103 patients treated by esmolol, 86 were found with improved
clinical symptoms, with the effective rate of 83.5%. 59 of the 86 cases were found markedly effective, in which the
symptoms were completely remitted after (68±21) min, the heart rate and blood pressure were significantly decreased,
P<0.01, and ST segment recovered to baseline P<0.01. Conclusion Coronary artery disease counts and stenosis are
related to the incidence of myocardial ischemia. Esmolol can relieve myocardial ischemia induced by coronary artery
disease quickly, safely and effectively.

      【Key words】 Esmolol; Coronary heart disease; Myocardial ischemia