2024 年第 10 期 第 19 卷

艾司洛尔联合卡维地洛对冠心病心肌缺血患者心率收缩压乘积及血清应激诱导蛋白2水平的影响

Impacts of esmolol combined with carvedilol on heart rate-systolic pressure product and serum Sestrin2 level in patients with coronary atherosclerotic heart disease myocardial ischemia

作者：何改鸿李祯

英文作者：He Gaihong Li Zhen

单位：西安交通大学第一附属医院榆林医院药剂科，榆林719000

英文单位：Department of Pharmacy Yulin Hospital First Affiliated Hospital of Xi′an Jiaotong University Yulin 719000 China

关键词：冠心病(冠状动脉粥样硬化性心脏病)；心肌缺血；卡维地洛；艾司洛尔

英文关键词：Coronaryatheroscleroticheartdisease;Myocardialischemia;Carvedilol;Esmolol

• 摘要：

• 目的 探讨艾司洛尔联合卡维地洛对冠心病（冠状动脉粥样硬化性心脏病）心肌缺血患者心率收缩压乘积（RPP）及血清应激诱导蛋白2（Sestrin2）水平的影响。方法 选择2021年3月至2023年3月西安交通大学第一附属医院榆林医院收治的冠心病心肌缺血患者106例，按照随机数字表法分为观察组和对照组，各53例。对照组采用卡维地洛治疗，观察组在对照组的基础上加用艾司洛尔治疗。2组均持续治疗8周。比较2组总有效率、心电图检查结果、心肌供氧相关指标、血清Sestrin2水平及不良反应发生情况。结果 观察组总有效率高于对照组［90.6%（48/53）比75.5%（40/53）］，差异有统计学意义（P=0.038）。治疗后2组心肌缺血总负荷、24 h内ST段压低次数、压低持续时间、心率、收缩压、RPP水平均低于治疗前，且观察组均低于对照组（均P＜0.05）。治疗后2组血清Sestrin2水平均低于治疗前，且观察组血清Sestrin2水平低于对照组［（8.1±1.0）μg/L比（10.1±1.6）μg/L］（均P＜0.001）。观察组不良反应总发生率低于对照组［11.3%(6/53)比47.2%(25/53)］（P＜0.001）。结论 冠心病心肌缺血患者接受艾司洛尔和卡维地洛两种药物联合治疗，效果较好，可有效改善患者心肌缺血状况，调节心率与血压水平，减少心肌耗氧量，且不良反应较少。 

• Objective To investigate the impacts of esmolol combined with carvedilol on the heart rate-systolic blood pressure product (RPP) and serum Sestrin2 level in patients with coronary atherosclerotic heart disease (CHD) and myocardial ischemia. Methods A total of 106 patients with CHD and myocardial ischemia admitted to Yulin Hospital, First Affiliated Hospital of Xi′an Jiaotong University from March 2021 to March 2023 were selected. According to the random number table method, they were divided into the observation group and the control group, with 53 cases in each group. The control group was treated with carvedilol, and the observation group was treated with esmolol on the basis of the control group. Both groups were treated for 8 weeks. The total effective rate, electrocardiogram examination results, myocardial oxygen supply related indicators, serum Sestrin2 levels and adverse reactions were compared between the two groups. Results The total effective rate of observation group was higher than that of control group［90.6%(48/53) vs 75.5%(40/53)］(P=0.038). After treatment, the total myocardial ischemic load, the number and duration of ST segment depression within 24 h, heart rate, systolic blood pressure and RPP levels in the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (all P＜0.05). After treatment, the serum Sestrin2 levels in both groups were lower than those before treatment, and the serum Sestrin2 level in the observation group was lower than that in the control group［(8.1±1.0)μg/L vs (10.1±1.6)μg/L］(all P＜0.001). The total incidence of adverse reactions in the observation group was lower than that in the control group ［11.3%(6/53) vs 47.2%(25/53)］(P＜0.001). Conclusion The combination of esmolol and carvedilol is effective in the treatment of patients with CHD and myocardial ischemia, which can effectively improve the myocardial ischemia status of patients, regulate heart rate and blood pressure levels, reduce myocardial oxygen consumption, and has fewer adverse reactions.