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冠状动脉内溶栓疗法是治疗急性心肌梗塞(AMI)的一大进展,它能减少梗塞面积,保持心功能,提高患者的生存率。但是溶栓疗法尽管作用很大,可存活的AMI似有再梗塞的心脏性猝死的危险。辅助于其它药物治疗,如β-受体阻滞剂镁、硝酸盐制剂、钙拮抗剂和血管紧张素转换酶抑制剂是值得进一步探讨的。 1 β-受体阻滞剂 β阻滞剂通过减慢心率,降低血压,抑制心肌收缩力从而使心肌耗氧减少。此外,能对抗在AMI时增高的儿茶酚胺浓度。 在总计27个包括2700患者随机试验中检查β阻滞剂对住院死亡率、再梗塞及心跳停止的影响,AMI早期(发病12小时内)静脉给予β阻滞显示,能
Intra-coronary thrombolysis is a major advance in the treatment of acute myocardial infarction (AMI), which reduces infarct size, maintains cardiac function, and improves patient survival. However, thrombolytic therapy, despite its effect, seems to be associated with the risk of sudden infarction and sudden cardiac death in surviving AMI. Assisted in other medical treatments, such as β-blockers magnesium, nitrate preparations, calcium antagonists and angiotensin converting enzyme inhibitors is worth further study. Β-blockers β-blockers reduce myocardial oxygen consumption by slowing heart rate, lowering blood pressure and inhibiting myocardial contractility. In addition, it is able to combat elevated catecholamines at AMI. The effect of beta blockers on in-hospital mortality, reinfarction and heartbeat was examined in a total of 27 randomized trials involving 2700 patients. Intravenous administration of beta block in the early AMI (within 12 hours of onset)