梗死相关动脉无顺行血流的急性心肌梗死后患者长期β受体阻滞剂治疗的有益作用

Beneficial effect of long-term beta blockade after acute myocardial infarction in patients without anterograde flow in the infarct artery.

作者信息

Glamann D B, Lange R A, Hillis L D

机构信息

Department of Internal Medicine (Cardiovascular Division), University of Texas Southwestern Medical Center, Dallas 75235.

出版信息

Am J Cardiol. 1991 Jul 15;68(2):150-4. doi: 10.1016/0002-9149(91)90735-4.

DOI:10.1016/0002-9149(91)90735-4

PMID:1676557

Abstract

Previous studies have shown that long-term survival after acute myocardial infarction (AMI) is improved by beta-adrenergic blockade and anterograde flow in the infarct artery. This study was done to assess the influence of beta blockade on mortality in survivors of AMI without anterograde flow. Over 9.5 years, 113 subjects (87 men and 26 women, aged 26 to 66 years) with AMI and no anterograde flow in the infarct artery and no disease of the other arteries were medically treated for 48 +/- 28 (mean +/- standard deviation) months. Forty-six patients received long-term beta blockade (group I), whereas 67 did not (group II). The groups were similar in age, sex, cardioactive medications, left ventricular performance and infarct artery. Of the 46 group I subjects, 1 (2%) died of cardiac causes; in contrast, 20 (30%) of the group II patients died of cardiac causes (p = 0.007 compared with group I). Thus, in survivors of AMI without anterograde flow in the infarct artery, mortality is markedly reduced by long-term beta blockade.

摘要

以往研究表明，急性心肌梗死（AMI）后长期生存可通过β-肾上腺素能阻滞剂和梗死相关动脉的顺行血流得到改善。本研究旨在评估β受体阻滞剂对梗死相关动脉无顺行血流的AMI存活者死亡率的影响。在超过9.5年的时间里，对113例梗死相关动脉无顺行血流且无其他动脉疾病的AMI患者（87例男性和26例女性，年龄26至66岁）进行了48±28（平均±标准差）个月的药物治疗。46例患者接受长期β受体阻滞剂治疗（I组），而67例未接受（II组）。两组在年龄、性别、心血管活性药物、左心室功能和梗死相关动脉方面相似。I组的46例患者中，1例（2%）死于心脏原因；相比之下，II组的20例（30%）患者死于心脏原因（与I组相比，p = 0.007）。因此，在梗死相关动脉无顺行血流的AMI存活者中，长期β受体阻滞剂可显著降低死亡率。