【摘要】 目的观察美托洛尔联合单硝酸异山梨酯治疗围手术期心肌缺血的非心脏手术患者对hs-CRP、s E-selectin的影响。方法选取我院围手术期心肌缺血患者300例,随机分为A、B、C三组,A组术前、术后均给予单硝酸异山梨酯缓释片30 mg,口服,1次/d;B组术前、术后均给予美托洛尔缓释片23.75 mg,口服,1次/d;C组术前、术后均给予单硝酸异山梨酯缓释片30 mg,口服,1次/d以及美托洛尔缓释片23.75 mg,口服,1次/d。用ELISA法测定术前及术后72 h hs-CRP、s E-selectin浓度。结果联合用药后C组心率、收缩压、舒张压小于单独用药,但心率、收缩压、舒张压差异无统计学意义(P>0.05);心电图改善情况优于单独用药的其他两组,差异有统计学意义(P<0.05);术后hs-CRP较术前均升高,s E-selectin较术前降低,但C组改变的幅度优于A组、B组,差异有统计学意义(P<0.05)。结论美托洛尔联合单硝酸异山梨酯具有提高治疗围手术期心肌缺血的疗效,可降低心率、收缩压、舒张压,可改善心电图及hs-CRP、s E-selectin浓度,检测二者水平可用于评估心肌缺血的治疗效果。更多还原

【Abstract】 Objective To investigate the effect of metoprolol combined with isosorbide mononitrate on hs-CRP and s Eselectin in non-cardiac surgery patients with perioperative myocardial ischemia. Methods 300 patients with perioperative myocardial ischemia were selected and randomly divided into three groups: group A, group B, group C. In group A,30 mg isosorbide mononitrate sustained-release tablets were orally given before and after the operation, once a day; in group B, 23.75 mg metoprolol sustained-release tablets were orally given before and after the operation, once a day; in group C, 30 mg isosorbide mononitrate sustained-release tablets were orally given before and after the operation, once a day, and also 23.75 mg metoprolol extended-release tablets were orally given, once a day. The concentrations of hs-CRP and s E-selectin were measured by ELISA before and 72 hours after operation. Results After combined administration,the heart rate, systolic blood pressure and diastolic blood pressure of group C were lower than those in single administration of drugs, but the differences of heart rate, systolic blood pressure and diastolic blood pressure were not statistically significant(P>0.05); ECG improvement was better than that in the other two groups receiving single administration, and the difference was statistically significant(P<0.05); the levels of hs-CRP after the surgery were increased and the levels of s E-selectin after the surgery were decreased, but the degree of improvement in group C was better than that in group A and B. The differences were statistically significant(P<0.05). Conclusion Metoprolol combined with isosorbide mononitrate can increase the curative effect of perioperative myocardial ischemia, reduce heart rate, systolic blood pressure and diastolic blood pressure, improve electrocardiogram and the concentration of hs-CRP and s E-selectin. The detection of both levels can be used to assess the therapeutic effect of myocardial ischemia.更多还原