Risøe C, Kirkeby O J, Grøttum P, Sederholm M, Kjekshus J K
Br Heart J. 1987 Jan;57(1):28-31. doi: 10.1136/hrt.57.1.28.
Body temperature was studied in 65 patients admitted to hospital within four hours of the onset of symptoms of acute myocardial infarction. Thirty three patients had been randomly assigned to intravenous timolol treatment and 32 to placebo treatment. Infarct evolution was assessed by continuous vectorcardiography and creatine kinase release. Maximum and mean temperatures during the first eight days were significantly lower in the timolol group, who were discharged from hospital one day earlier. Eight patients in the placebo group had temperatures of greater than 39 degrees compared with one in the timolol group. Both the mean temperature and the maximum temperature correlated significantly with indices of infarct size and ischaemic area as estimated by cumulative creatine kinase release, QRS vector difference, and ST vector magnitude. The results were consistent with the view that reduction of infarct size may partly explain the reduced pyrexial response after timolol treatment. Other mechanisms are probably also involved in larger infarcts. Because high fever has detrimental haemodynamic effects in acute myocardial infarction, reduction of this response may be beneficial. The results support the early use of beta adrenoceptor blockade in acute myocardial infarction.
对65例在急性心肌梗死症状发作后4小时内入院的患者进行了体温研究。33例患者被随机分配接受静脉注射噻吗洛尔治疗，32例接受安慰剂治疗。通过连续心电向量图和肌酸激酶释放评估梗死进展情况。噻吗洛尔组在前八天的最高体温和平均体温显著较低，且该组患者提前一天出院。安慰剂组有8例患者体温高于39度，而噻吗洛尔组只有1例。平均体温和最高体温均与通过累积肌酸激酶释放、QRS向量差异和ST向量幅度估算的梗死面积及缺血区域指标显著相关。结果支持这样的观点，即梗死面积减小可能部分解释了噻吗洛尔治疗后发热反应降低的原因。其他机制可能也与较大梗死有关。由于高热在急性心肌梗死中有有害的血流动力学影响，减轻这种反应可能有益。这些结果支持在急性心肌梗死中早期使用β肾上腺素能受体阻滞剂。
