Marcillac-Desruennes M, Weber S, Degeorges M
Ann Cardiol Angeiol (Paris). 1984 Dec;33(8):519-23.
Several experimental studies have demonstrated that the early administration of beta blockers in the setting of an acute myocardial infarction (in the first six hours) tended to diminish the area of myocardial necrosis. Numerous attempts to limit infarct size with beta blockers have occurred over the past ten years. Without a reliable and reproducible method to measure necrosed tissue, it has been difficult to evaluate the effectiveness of this therapy. Presently available studies have demonstrated, however, that beta blockers are well tolerated in the setting of an acute infarction as long as none of the usual contraindications are present. The majority (but not all) of these studies indicated improvement in parameters used to determine the amount of tissue necrosis and a tendency (not always significant due to the small numbers studied) to decrease morbidity and mortality during hospitalization. One study using metoprolol administered during the acute phase and continued during the first three months demonstrated a significant decrease in mortality. The results of this study are very demonstrative, nevertheless, once the acute necrotic phase is over, it is difficult to ascertain whether diminished tissue necrosis or the preventive effect of beta blockers is responsible for these findings until a recurrence or sudden death occurs.
多项实验研究表明，在急性心肌梗死发病初期（头6小时内）尽早使用β受体阻滞剂往往会减小心肌坏死面积。在过去十年里，人们多次尝试用β受体阻滞剂来限制梗死面积。由于缺乏可靠且可重复的方法来测量坏死组织，很难评估这种治疗方法的有效性。然而，目前的研究表明，只要不存在常见的禁忌证，β受体阻滞剂在急性梗死情况下耐受性良好。这些研究中的大多数（但并非全部）表明，用于确定组织坏死量的参数有所改善，且住院期间发病率和死亡率有降低的趋势（由于研究样本量小，这种趋势并不总是显著）。一项使用美托洛尔的研究显示，在急性期给药并持续三个月，死亡率显著降低。不过，这项研究的结果很有说服力，一旦急性坏死期结束，在复发或猝死发生之前，很难确定是组织坏死的减轻还是β受体阻滞剂的预防作用导致了这些结果。
