地尔硫治疗急性非ST段抬高型心肌梗死合并心力衰竭的临床效果  

Clinical efficacy of diltiazem in treatment of acute non-ST-segment elevation myocardial infarction complicated with heart failure

作　　者：杨礼文[1] 夏豪[1] 田国卫[1] 郑雅格 

机构地区：[1]武汉大学人民医院心内科,心血管病湖北省重点实验室,武汉市430060

出　　处：《广西医学》2017年第6期757-760,共4页Guangxi Medical Journal

基　　金：国家自然科学基金(81270184)

摘　　要：目的探讨地尔硫治疗急性非ST段抬高型心肌梗死(ANSTEMI)合并心力衰竭的疗效与安全性。方法将80例ANSTEMI且合并心力衰竭的患者随机分为地尔硫组40例和对照组40例,对照组给予常规治疗,地尔硫组在常规治疗的基础上静脉给予地尔硫治疗,比较两组患者心绞痛缓解、ST段回升、心功能改善及不良反应发生情况。结果地尔硫组心绞痛缓解程度、缺血性ST段改善程度均优于对照组(P<0.05);治疗后两组患者SBP、DBP、HR均较治疗前下降(P<0.05),且治疗后地尔硫组HR明显低于对照组(P<0.05),但两组治疗后SBP、DBP比较,差异无统计学意义(P>0.05);治疗后两组氨基末端脑钠肽前体(NT-pro BNP)均较治疗前下降(P<0.05),左室射血分数(LVEF)均较前升高(P<0.05),但治疗后两组NT-pro BNP、LVEF比较,差异无统计学意义(P>0.05);两组治疗前后左室舒张末期内径比较,差异无统计学意义(P>0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论静脉应用地尔硫可显著缓解ANSTEMI合并心力衰竭患者的心绞痛症状而不加重心力衰竭,疗效显著、安全可靠。Objective To investigate the efficacy and safety of diltiazem in the treatment of acute non-ST-segment elevation myocardial infarction（ ANSTEMI） complicated with heart failure. Methods A total of 80 patients with ANSTEMI complicated with heart failure were randomly divided into diltiazem group and control group,with 40 cases in each group. The control group received conventional treatment,and the diltiazem group was intravenously administered diltiazem on the basis of the conventional treatment. The relief of angina pectoris,elevation of ST segment,improvement of heart function and the incidence of adverse effects were compared between the two groups. Results The relief of angina pectoris and the improvement of ischemic ST segment in the diltiazem group were superior to those in the control group（ P〈0. 05）. After treatment,SBP,DBP and HR decreased in both groups（ P〈0. 05）,and HR in the diltiazem group was significantly lower than that in the control group（ P〈0. 05）,but there were no significant differences in the SBP or DBP between the two groups（ P〈0. 05）. After treatment,N-terminal pro-B-type natriuretic peptide（ NT-pro BNP） decreased and left ventricular ejection fraction（ LVEF） increased in both groups（ P〈0. 05）,but there were no significant differences in the NT-pro BNP or LVEF between the two groups（ P〈0. 05）. There was no significant difference in the left ventricular end diastolic dimension between the two groups before and after treatment（ P〈0. 05）. No significant difference was fund in the incidence of adverse effects between the two groups（ P〈0. 05）. Conclusion For the patients with ANSTEMI complicated with heart failure,the intravenous administration of diltiazem can significantly relieve angina pectoris but does not exacerbate heart failure,and is significantly effective,safe and reliable.

关 键 词：急性非ST段抬高型心肌梗死 心力衰竭 地尔硫[艹卓] 

分 类 号：R542.22[医药卫生—心血管疾病]