摘要
目的探究前壁急性ST段抬高型心肌梗死(STEMI)直接经皮冠状动脉介入治疗(PCI)后伴心力衰竭的药物治疗疗效对比。方法选取云浮市人民医院心血管内科2021年7月—2023年6月期间住院的90例前壁STEMI直接PCI后伴心力衰竭患者,按照随机数字表法将其分为A、B、C三组,各30例。A组采用呋塞米+硝酸甘油治疗,B组采用呋塞米+硝酸甘油+新活素治疗,C组采用呋塞米+硝酸甘油+多巴胺治疗。对比三组治疗后的临床疗效、心功能[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、氨基末端B型利钠肽前体(NT-ProBNP)]及临床指标。结果①三组治疗总有效率相比(P<0.05);其中B、C两组治疗总有效率均明显高于A组(P<0.05);②治疗3 d后,三组LVEF水平均升高(P>0.05),NT-ProBNP、LVESD、LVEDD水平均降低,且B、C两组较A组NT-ProBNP、LVESD、LVEDD水平较低(P<0.05);③三组患者住院时间、再次入院率比较,差异具有统计学意义(P<0.05);其中B、C两组住院时间、再次入院率低于A组(P<0.05)。结论呋塞米+硝酸甘油联合新活素或多巴胺治疗前壁STEMI直接PCI后伴心力衰竭患者疗效更加显著,能够改善患者心功能,缩短住院时间,降低再次入院率,值得临床推广。
Objective To compare the therapeutic impact of acute anterior wall ST-segment elevation myocardial infarction(STEMI)and primary percutaneous coronary intervention(PCI)in patients with heart failure.Methods 90 patients with anterior wall STEMI with heart failure after primary PCI were selected from the cardiovascular Department of Yunfu People's Hospital from July 2021 to June 2023,and they were split into three groups using the random number expression approach,each group containing 30 examples.Group A was treated with furosemide+nitroglycerin,group B was treated with furosemide+nitroglycerin+neoactin,and group C was treated with furosemide+nitroglycerin+dopamine.The clinical efficacy,cardiac function[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),amino terminal B-type natriuretic peptide precursor(NT-ProBNP)]and clinical indexes of the three groups after treatment were compared.Results①There was significant difference in total treatment rate among the three groups(P<0.05).Group B and C had significantly greater total effective rates than group A.(P<0.05).②After 3 days of treatment,the levels of LVEF in the three groups were increased(P>0.05),while the levels of NT-ProBNP,LVESD and LVEDD were decreased,and the levels of NT-ProBNP,LVESD and LVEDD in group B and C were lower than those in group A(all P<0.05).③The length of hospital stay and readmission rate of the three groups were significantly different(P<0.05).The length of hospital staying and readmission rate of group B and C were lower than those of group A(P<0.05).Conclusion Furosemide+nitroglycerin combined with neoactin or dopamine in the treatment of anterior wall STEMI patients with heart failure after primary PCI is more effective,can enhance patients heart health,shorten the length of hospital stay,reduce the readmission rate,worthy of clinical promotion.
作者
陈章瑜
张志广
陈棣培
CHEN Zhangyu;ZHANG Zhiguang;CHEN Dipei(Yunfu People's Hospital,Yunfu 527300,China)
出处
《现代医院》
2024年第3期479-481,485,共4页
Modern Hospitals
基金
广东省自然科学基金项目(2018A030313821)
云浮市医药卫生科技计划项目(20210301)。
关键词
前壁急性ST段抬高型心肌梗死
经皮冠状动脉介入
心力衰竭
呋塞米
硝酸甘油
新活素
多巴胺
Acute anterior wall st-segment elevation myocardial infarction
Primary percutaneous coronary intervention
Heart failure
Furosemide
Nitroglycerin
Neoactivin
Dopamine
