硝酸异戊酯与硝酸甘油在老年急性心肌梗死患者急救治疗中的应用效果比较  

Comparative Study for Application Effect in the Emergent Treatment of Elderly Patients with Acute Myocardial Infarction between Isoamyl Nitrate and Nitroglycerin

作　　者：康忠良[1] 

机构地区：[1]四川省宜宾市第三人民医院,644000

出　　处：《实用心脑肺血管病杂志》2015年第12期102-104,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的比较硝酸异戊酯与硝酸甘油在老年急性心肌梗死患者急救治疗中的应用效果。方法选取宜宾市第三人民医院心内科2009年6月—2013年12月收治的老年急性心肌梗死患者60例,均为120急救患者,根据治疗方式不同分为硝酸异戊酯组27例和硝酸甘油组33例。硝酸异戊酯组患者给予硝酸异戊酯急救治疗,硝酸甘油组患者给予硝酸甘油急救治疗,持续治疗3周。比较两组患者临床疗效及治疗前和治疗24 h后血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、B型钠尿肽水平,并观察治疗期间不良反应发生情况。结果硝酸异戊酯组患者临床疗效优于硝酸甘油组(Z=-2.143,P=0.032)。治疗前两组患者血清CK、CK-MB及B型钠尿肽水平比较,差异无统计学意义(P>0.05);治疗24 h后硝酸异戊酯组患者血清CK、CK-MB及B型钠尿肽水平低于硝酸甘油组(P<0.05)。硝酸异戊酯组患者不良反应发生率为18.5%,硝酸甘油组患者为30.3%,差异无统计学意义(P>0.05)。结论硝酸异戊酯在老年急性心肌梗死患者急救治疗中的应用效果优于硝酸甘油,能明显改善患者心功能,且安全性较高。Objective To compare the application myocardial infarction between isoamyl nitrate and nitroglycerin. effect in the emergent treatment of elderly patients with acute Methods From June 2009 to December 2013, a total of 60 elderly patients with acute myocardial infarction were selected in the Department of Cardiology, the Third People＇s Hospital of Yibin, and they were divided into A group （n = 27） and B group （ n = 33） according to therapeutic methods. Patients of A group were given isoamyl nitrate, while patients of B group were given nitroglycerin, both groups continuously treated for 3 weeks. Clinical effect, serum levels of CK, CK-MB and BNP before treatment and after 24 hours of treatment were compared between the two groups, and the incidence of adverse reactions during treatment was observed. Results The clinical effect of A group was statistically significantly better than that of B group （ Z = - 2. 143, P = 0. 032）. No statistically significant differences of serum level of CK, CK-MB or BNP was found between the two groups before treatment （ P 〉 0. 05 ） , while serum levels of CK, CK-MB and BNP of A group were statistically significantly lower than those of B group after 24 hours of treatment （P 〈 0.05）. The incidence of adverse reactions of A group was 18.5%, that of B group was 30. 3%, the difference was not statistically significantly different （ P 〉 0.05 ）. Conclusion Isoamyl nitrate has better application effect in the emergent treatment of elderly patients with acute myocardial infarction than nitroglycerin, can effectively improve the cardiac function, has relatively high safety.

关 键 词：心肌梗死 老年人 硝酸甘油 硝酸异戊酯 急救 疗效比较研究 

分 类 号：R542.22[医药卫生—心血管疾病]