高血压患者发生急性心肌梗死后血压变化及临床特征探讨

Analysis of the changes of blood pressure and clinical features in patients with hypertension after complicating acute myocardial infarction

目的:探讨高血压患者发生急性心肌梗死后的血压变化及临床特征。方法:选取我院收治的120例急性心肌梗死患者,将合并高血压患者归为观察组(65例),非高血压患者归为对照组(55例)。比较2组患者发生急性心肌梗死后血压变化、临床特征和并发症的发生。结果:观察组患者无胸痛心肌梗死和心肌肥厚的发生率分别为38.4%和63.1%,均显著高于对照组(P<0.05)。发生心肌梗死后血压下降发生率高达81.5%,收缩压下降(31±12)mmHg,均显著高于对照组(P<0.05)。心功能Ⅲ级和Ⅳ级患者占比分别为18.5%和12.3%,显著高于对照组(P<0.05)。心力衰竭、室速室颤、Ⅱ度以上房室传导阻滞和死亡等并发症的发生率均显著高于对照组(P<0.05)。结论:有效控制血压,逆转心肌肥厚,增强心功能,有利于改善高血压合并急性心肌梗死患者的临床预后。

Objective：Analysis of the changes of blood pressure and clinical features in patients with hypertension after acute myocardial infarction.Method：One hundred and twenty acute myocardial infarction patients treated in our hospitals were selected and divided into two groups：complicating hypertension group（observation group,n=65）and normal blood pressure group（control group,n=55）.The changes of blood pressure,clinical features and complications were compared.Result：The incidences of non-chest pain,and hypertrophy were 38.4%and 63.1%in observation group,respectively,which were significantly higher than the control group（P〈0.05）.The incidence of low blood pressure was 81.5% in observation group,which was higher than the control group（P〈0.05）.The average decrease in SBP was（31±12）mmHg,which was higher than the control group（P〈0.05）.The proportion of patients with Grade III and grade IV cardiac function was 18.5% and 12.3%,respectively,which were significantly higher than the control group（P〈0.05）.The incidences of heart failure,ventricular fibrillation,ventricular tachycardia,atrioventricular block degree II and death were significantly higher than the control group（P〈0.05）.Conclusion：Control of blood pressure effectively,reversal the cardiac hypertrophy,and strengthen the heart function can improve the clinical outcomes of patients with hypertension after acute myocardial infarction.