International Circulation: Is it better to avoid early BBs treatment for patients with AMI?
　　国际循环：对于AMI患者，避免采用早期BBS疗法是不是更好呢？
　　Prof. Stone: In general， no， we believe there is an important role for β-blockers in patients with acute myocardial infarction. There have been no randomized trials of intravenous β-blocker useprimary to angioplasty but there is a lot of observational data which after multivariable adjustment suggest that IV β-blockers use. For example， metaprolallopressor， given 15mg over 15 minutes， given before the PCI procedure decreases the incidence of matricularfibrillation and improves long term survival. Absent contraindication such as， heart block， heart failure or severe asthma， we like to use intravenous β-blockers. Post-myocardial infarction， a wealth of data is available in the post MI situation and in patients with hypertension that β-blockers are beneficial effects. So that almost anybody， post myocardial infarction with any evidence of hypertension or that do not have contraindication we do try to have on β-blockers. Of course， patients with left ventricular dysfunction may also benefit from β-blockade especially with more selective agents.
　　Stone 教授：在一般情况下不是这样的，我们认为β受体阻滞剂对于急性心肌梗死患者具有重要作用。目前尚缺乏在血管成形术之前静脉注射β受体阻滞剂的随机试验，但是多变量调整后的大量观察数据建议应用第IV代β受体阻滞剂。比如，在PCI手术前15分钟内给予15毫克美托洛尔，用于降低室颤的发生率并提高长期存活率。禁忌症，如心脏传导阻滞，心衰或者严重哮喘，我们一般使用静脉注射β受体阻滞剂。心肌梗死后，MI后的表现和高血压患者的大量数据证明β受体阻滞剂能够带来有益的疗效。所以，我们对几乎所有的心肌梗死后显示有高血压存在或没有禁忌症的患者，都尝试采用β受体阻滞剂。当然，具有左心功能不全的患者也可能从β受体阻滞剂的使用中受益，尤其是有更多的选择药物时。