洋地黄治疗心肌梗塞并发心力衰竭的研究

Myocardial Infarction Complicated with Heart Failure:Problems of Digitalis Therapy

本文分析了550例心肌梗塞(MI)并发心衰患者,用与未用洋地黄治疗对病死率的影响。结果表明,洋地黄治疗组病死率(30.2％)显著高于未用洋地黄治疗组(18.2％,P<0.01),其中洋地黄治疗组死于心脏原因者占91.5％。拼除高危因素后,洋地黄治疗组病死率仍显著高于未用洋地黄治疗组(6.9％对0.6％,P<0.05),结果提示病死率增加可能与洋地黄治疗有关。

Adverse effect of digitalis on mortality was compared between 550 patients with myocardial infarction complicated with heart failure treated and not treated with digitalis in hospital.The mortality rate of the digitalis-treated group(30.2%) was significantly higher than that of the non-treated group (18.2%) (P<0.01). 91.5% of the digitalis treated patients died of cardiac cause. With the exclusion of the high risks of severe cardiac variables, the mortality rate of the digitalis-treated group was still higher than that of the non-treated group (6.9 vs 0.6%) (P<0.05). These findings indicated that the use of digitalis in myocardial infarction patients might increase their mortality rate. Reviewing the current literatures, the possible pathogenesis of the higher mortality rate and the trends of management of myocardial infarction complicated with heart failure was discussed.