Clinical Observation Of β-blockers Are Used To Treat Patients With Sympathetic Excitatory Cerebral Infarction

Objective:To discuss the inhibitory effect of β-blockers on sympathetic excitability and cardiac protection in patients with acute cerebral infarction with sympathetic excitability.This study provides references for improving the efficacy and prognosis of patients.Methods:The experimental method of case-control was selected and 60 patients with acute cerebral infarction admitted to the hospital from January 2017 to January 2018 were selected in strict accordance with the experimental diagnostic criteria,inclusion criteria and exclusion criteria.After heart rate variability analysis of 24 h dynamic electrocardiogram system,they were determined as sympathetic nerve excitation(SDNN<100ms).With informed consent,the patients were randomly divided into 32 patients in the observation group and 28 patients in the control group according to the random number table method.All the 60 patients received standard treatment for cerebral infarction,including: bed rest,oxygen inhalation,electrocardiogram monitoring,and monitoring of temperature,blood glucose and blood pressure.Blood glucose was controlled at about 7.0mmol/L,blood pressure was initially maintained at 180-220/110-130 mmhg,and gradually decreased to 160-180/100-110 mmhg for24-48 hours.Symptomatic treatment of intracranial hypertension,pneumonia,epilepsy and other complications,clinical treatment of arrhythmias to be given antiarrhythmic drugs(except beta blockers).On top of the basic treatment in the treatment group,the observation group received individualized intravenous treatment with asimolol,which was injected with 10 mg/ ml solution of asimolol injection.First,0.5 mg/ kg was injected silently for 1 min,followed by a micro pump.The initial maintenance dose was 0.05mg/kg/ min and the maximum dose was0.2mg/kg/ min.The final maintenance amount is determined according to the clinicaleffect,and the end point is reached.In case of adverse reactions,immediately stop the drug and observe.On the day of admission and one week after admission,patients in both groups underwent 24-hour dynamic electrocardiogram monitoring and SDNN values were recorded.Plasma levels of cTnI and NT-proBNP were measured at two time points,bedside electrocardiogram monitoring and electrocardiogram monitoring of malignant arrhythmia,total hospital expenses were counted after discharge,and the number of death cases were counted by return visit at 30 days,and statistical analysis was conducted between the two groups.Results:1.There was no significant difference in the general data between the two groups(P>0.05),indicating that the two groups were comparable.2.The SDNN index in the observation group and the control group was generally improved after treatment,and the SDNN value in the observation group was more obvious than that in the control group.Before treatment,SDNN of the two groups was compared with P=0.588,and the difference was not statistically significant.After treatment,the SDNN of the two groups was compared with P=0.017 < 0.05,and the difference was statistically significant.This suggests that beta blockers can effectively inhibit sympathetic activity in patients with cerebral infarction.3.After treatment,TnI concentration in the observation group decreased more obviously than that in the control group.The comparison of TnI between the two groups before treatment was not statistically significant(P=0.779).After treatment,TnI of the two groups was compared with P=0.033 < 0.05,and the difference was statistically significant.It indicates that beta blockers can effectively reduce TnI level in plasma and improve myocardial ischemia in patients with sympathetic excitation after cerebral infarction.4.The decrease of NT-proBNP level in the observation group was more obvious than that in the control group.The difference in BNP between the two groups before treatment was not statistically significant(P=0.789).The difference of BNP between the two groups after treatment was statistically significant P=0.021 < 0.05.It indicates that beta blockers can significantly reduce the level of NT-proBNP in plasma and improve cardiac function in patients with sympathetic excitation after cerebral infarction.5.No malignant arrhythmia occurred before treatment in the observation group and the control group.No malignant arrhythmia was found in the observationgroup during the treatment period,1 case of frequent ventricular premature beats and1 case of short-term ventricular tachycardia occurred in the control group.The incidence of malignant arrhythmia in the two groups was compared P=0.214>0.05,and the difference was not statistically significant..6.The observation group and the control group were visited 30 days after onset.One case died in the observation group and three in the control group.Comparison of mortality within 30 days P=0.511 > 0.05.Although the mortality rate was higher in the control group,the difference was not statistically significant.7.With the exception of beta blockers,both groups were treated with a homogeneous regimen during their hospital stay.The final total hospital expenses were compared P=0.032<0.05,and the difference was statistically significant.It indicates that the application of beta blockers in patients with sympathetic excitability after cerebral infarction can effectively reduce the total cost of hospitalization and reduce the financial burden of patients.Conclusion:β-blockers can effectively reduce sympathetic nerve excitatory type of cerebral infarction patients sympathetic activity,may be helpful to improve myocardial ischemia,improve cardiac function,do not increase the incidence of malignant arrhythmia,reduce the total hospital costs,reduce the financial burden of patients.