摘要
目的探讨缬沙坦联合美托洛尔对急性心肌梗死(AMI)患者心功能的影响。方法选取我院2010年1月至2014年1月收治入院的符合WHO规定的AMI诊断标准的患者200例,采用随机抽样方法分为两组,每组100例,两组患者给予吸氧、止痛、扩冠、抗凝、营养心肌等对症治疗,对照组给予缬沙坦40 mg/d,1次/天,2周后无不良反应,剂量逐渐增至80 mg/d,1次/天,最大剂量160 mg/d。观察组患者在对照组治疗基础上联合应用美托洛尔6.25 mg,2次/d,若无不良反应,剂量每2周加倍上调一次,最大剂量25 mg,每天两次。两组疗程均6个月。比较两组患者治疗前后心功能指标、治疗8周心电图及6个月临床事件,并进行统计学分析。结果两组患者治疗前收缩、舒张功能比较差异无统计学意义(P>0.05);观察组患者治疗8周后左室短轴缩短率、射血分数、每搏量、心排血量、左室舒张早期快速充盈速率、左室收缩期血流峰值速度、E峰减速时间、等容舒张时间等指标与对照组比较差异均有统计学意义(P<0.05);观察组100例治疗后有87例ST段下降幅度>70 mm,出现心律失常者5例,无死亡、再入院病例,对照组100例64例ST段下降幅度>70 mm,再入院12例。两组比较差异有统计学意义(P<0.05)。结论缬沙坦联合美托洛尔能明显改善急性心肌梗死(AMI)患者心功能,效果显著,可在临床推广。
Objective To investigate the effects of valsartan combined with metoprolol in acute myocardial infarction（ AMI） patient＇s heart function influence. Methods 200 cases with AMI diagnostic criteria specified by WHO patients were selected in our hospital in 2010 January-2014 year in January admitted to the cases,adopting the method of random sampling were divided into two groups,100 cases in each group,two groups of patients given oxygen,pain,crown expansion,anticoagulation,myocardial nutrition,symptomatic treatment,the control group given valsartan 40 mg / d,1 times / day,no adverse reactions after 2 weeks,the dose gradually increased to 80 mg / d,1 times / day,observed the maximum dose of 160 mg / d. group patients in the control group based on the combination therapy of metoprolol 6. 25 mg,2 / d,if no adverse reactions,dosage of double every 2 weeks by a,the maximum dose of 25 mg,two every day. Two groups were treated for 6 months.The two groups before and after treatment in patients with cardiac function and clinical treatment of event 8 weeks of ECG and 6 months,and carries on statistics analysis. Results The two groups of patients before treatment systolic and diastolic function had no significant difference（ P〉0. 05）; patients in the observation group 8 weeks after the treatment,left ventricular fractional shortening and ejection fraction,stroke volume,cardiac output,left ventricular early diastolic rapid filling rate,left ventricular systolic peak velocity,peak E deceleration time and isovolumetric relaxation time index compared with the control group,the difference was statistically significant（ P〈0. 05）; 100 cases in observation group after treatment,87 cases of ST segment resolution 〉70 mm,5 cases of arrhythmia,no death,readmission patients,control group 100 cases of 64 cases of ST segment decrease 〉70mm,then 12 cases admitted to hospital. There was significant difference between two groups（ P〈0. 05）.Conclusions The combination of valsartan and metoprolol can improve the acute myocardial infarction（ AMI）patients with heart function,the effect is significant,can be popularized in clinical.
出处
《齐齐哈尔医学院学报》
2015年第17期2521-2523,共3页
Journal of Qiqihar Medical University
