目的：探讨急性ST段抬高型心肌梗死患者服用美托洛尔后的自主神经失衡的改善和临床疗效。方法选取2013年5月至2014年5月就诊的急性ST段抬高型心肌梗死患者101例，随机分为治疗组50例和对照组51例。两组患者入院后均给予抗凝、调脂、抗血小板药物治疗，在此基础上对照组应用硝苯地平缓释片，治疗组应用琥珀酸美托洛尔缓释片。结果治疗后，治疗组心率变异性( HRV )时域、频域指标的积分均优于对照组（ P＜0.05，P＜0.01）；两组心功能均有不同程度改善（ P＜0.05），治疗组心肌梗死复发率为6.00%，低于对照组的11.10%，两组治疗后心脏标志物、血脂参数（除高密度脂蛋白胆固醇）、超敏C反应蛋白（hs－CRP）比较，差异均有统计学意义（ P＜0.05）。结论美托洛尔可提高急性ST段抬高型心肌梗死的HRV指标，恢复自主神经失衡，且在心功能恢复、减少复发次数、改善血脂及hs－CRP水平方面具有较好的疗效。%Objective To investigate the efficacy of metoprolol in Treating autonomic nervous system imbalance of patients with acute ST segment elevation myocardial infarction. Methods A 101 cases of patients with acute ST segment elevation myocardial infarction from May 2013 to May 2014 were selected and randomly divided into the treatment group of 50 cases and the control group with 50 cases. After admission,all patients were treated with anticoagulation,lipid-lowering and anti-platelet drugs,on this basis,the control group was given nifedipine(Ⅱ)and the treatment group metoprolol succinate. Results After treatment,HRV time domain and the fre-quency domain indicators of the treatment groups were obviously better than the control group ( P < 0. 05,P < 0. 01);the cardiac function of the two groups showed different degrees of improvement ( P < 0. 05);the reoccurrence rate of myocardial infarction in the treatment group was 6. 00%,which was obviously lower than 11. 10% in the control group ( P < 0. 05);after treatment,the cardiac markers,blood lipid parameters(except high density lipoprotein cholesterol),hs-CRP in the two groups had statistically significant dif-ferences ( P < 0. 05). Conclusions Metoprolol can improve HRV in the acute ST-segment elevation myocardial infarction,and has good efficacy in the restoration of the autonomic nervous imbalance and heart function,reducing the frequency of reoccurrence,improving blood lipid and hs-CRP.
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