【摘要】 目的:探讨β-受体阻滞剂美托洛尔对心交感神经的影响及心交感神经对心肌细胞分泌NT-proBNP的影响,为β-受体阻滞剂对AMI患者改善心功能的应用提供更多、更有力临床依据。方法:入选急性心肌梗死患者78例,随机分为美托洛尔治疗组和对照组,2组均行常规治疗。治疗组入院后即开始使用美托洛尔治疗,对照组未使用任何β-受体阻滞剂。2组维持治疗12个月,监测2组血浆去甲肾上腺素(norepinephrine,NE)、B型钠尿肽前体代谢产物(pro-B-type natriuretic peptide,NT-proBNP)及心功能超声指标左室舒张末容积(left ventricular end diastolic volume,LVEDV)、左室射血分数(left ventricular ejection fraction,LVEF)的动态变化,并严密随访心力衰竭事件的发生情况,比较2组间的差异。结果:在监测、随访12个月期间,治疗组血浆NE、NT-proBNP含量及LVEDV均显著低于对应的常规治疗组,而LVEF显著高于对照组(P<0.05);治疗组心力衰竭发生率亦显著低于对照组(P<0.01)。结论:美托洛尔可遏制心交感神经作用和心肌细胞分泌NT-proBNP,有益于心AMI患者心功能改善。更多还原

【Abstract】 Objective: To discuss the influence of β-receptor blocker on cardiac sympathetic nerve and Secretion of NT-proBNP,and to provide more basis for β-receptor blocker in improving AMI.Methods: 78 patients with acute myocardial infarction were randomly divided into two groups: Treated Group had Metoprolol and matched Group had no Metoprolol.At the same time both were treated by the same conventional therapy and clinical follow-up for 12 months.In the two groups,the concentrations of plasma Norepinephrine and NT-proBNP were measured before and after 2 months,4 months,6 months,8 months,10 months and 12 months of treatments;by ultrasound indicators the left ventricular end diastolic volume(LVEDV) and ejection fraction(LVEF) were measured and the events about heart failure were supervised.Results: In metoprolol group the concentrations of plasma norepinephrine,NT-proBNP and LVEDV were statistically different compared to in matched Group.LVEF was increases,P < 0.05;the incidence of heart failure was lower in treated group than in matched Group,P < 0.01.Conclusion: Metoprolol have a function of blocking cardiac sympathetic nerve that can influence the discharge of NT-proBNP by cardiac cell and improving cardiac function.更多还原