依折麦布联合美托洛尔治疗急性心肌梗死的临床研究OA

Objective:To investigate the efficacy of ezetimibe combined with metoprolol for acute myocardial infarction(AMI)and its effects on coronary blood flow velocity in the epicardium,factors related to ventricular remodeling,and heart rate variability(HRV).Methods:A total of 116 patients with AMI treated at our hospital from January 2021 to December 2024 were enrolled.Using a random number table method,the patients were assigned to a control group receiving metoprolol or an observation group receiving ezetimibe plus metoprolol,with 58 patients in each group.Coronary blood flow velocity in the epicardium[thrombolysis in myocardial infarction test(TIMI)grades];levels of factors related to ventricular remodeling[secreted frizzled-related protein 2(SFRP2),cysteinyl aspartate specific proteinase 3(CASP3)];HRV indices[standard deviation of all normal sinus RR intervals(SDNN),root mean square of successive differences between adjacent normal RR intervals(RMSSD),and standard deviation of the average of normal sinus RR intervals in all 5-minute segments(SDANN)];and cardiac function parameters[left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume(LVEDV)]were compared between the groups before and after treatment.Clinical efficacy and adverse reactions were also assessed.Results:After treatment,the TIMI grades of both groups of patients were better than those before treatment,and the observation group was better than the control group(P<0.05).SDNN,RMSSD,SDANN and LVEF all increased,and the values in the observation group were higher than those in the control group(P<0.05);SFRP2,CASP3 and LVEDV all decreased,and the values in the observation group were lower than those in the control group(P<0.05).The overall clinical response rate was higher in the observation group(93.10%)than in the control group(74.14%,P<0.05).The overall incidence of adverse reactions did not differ significantly between the groups(P>0.05).Conclusion:Ezetimibe combined with metoprolol in the treatment of AMI can improve therapeutic efficacy and the blood flow velocity of epicardial coronary arteries,reduce the levels of factors related to ventricular remodeling,correct abnormal HRV,and enhance cardiac function in patients with AMI without increasing the risk of adverse reactions.