洋地黄不同时期应用对早期急性心肌梗死合并心力衰竭再灌注后的效应分析

Analysis of application effect of digitalis in different periods for early acute myocardial infarction complicated with heart failure after reperfusion

目的研究与分析洋地黄不同时期应用对早期急性心肌梗死合并心力衰竭再灌注后的临床效果。方法选取我院在2014年4月~2016年7月收治的76例急性心肌梗死合并心力衰竭再灌注后的患者作为研究对象,采用奇偶分组法分为对照组和观察组,每组各38例。对照组患者在再灌注后期使用洋地黄进行治疗,而观察组患者则在再灌注早期使用洋地黄进行治疗。分别于治疗前和治疗后检测两组患者心率（HR）、射血分数（EF）、收缩压（SBP）以及左室舒张末期容积（LVEDV）等水平,对比以上各临床指标变化差异;同时记录两组患者出现的不良反应症状及人数,比较不良反应发生率;并于治疗后将两组患者的临床治疗效果进行比较。结果治疗前两组患者HR、EF、SBP及LVEDV各临床指标比较无明显差异,差异无统计学意义（P〉0.05）,治疗后两组患者HR、EF、SBP及LVEDV各临床指标均较治疗前低,差异有统计学意义（P〈0.05）,同时观察组患者HR、EF、SBP及LVEDV各临床指标较对照组显著改善（P〈0.05）。两组患者用药后不良反应发生率无明显差异（P〉0.05）,观察组患者治疗总有效率显著高于对照组（P〈0.05）。结论急性心肌梗死合并心力衰竭患者,在再灌注后早期（2 h）应用洋地黄临床效果较好,可显著降低患者HR、EF、SBP及LVEDV水平,且不良反应较少,安全性较高,值得在临床中推广与应用。

Objective To study and anayze the clinical effects of digitalis in different periods on patients with early acute myocardial infarction complicated with heart failure after reperfusion. Methods A total of 76 patients with acute myocardial infarction complicated with heart failure and who accepted treatments in our hospital from April 2014 to July 2016 were enrolled and divided into the control group and the observation group by the even and odd grouping method, with 38 cases in each group. Patients in the control group were treated with digitalis in the late stage of reperfusion while in the observation group of patients were treated with digitalis in the early stage of reperfusion. Heart rate （HR）, ejection fraction （EF）, systolic blood pressure（SBP） and left ventricular end diastolic volume（LVEDV） of two groups were respectively detected and compared before and after treatment. In addition, the adverse effects of the two groups and the rate of adverse reactions were recorded. Furthermore, the clinical treatment effect of the two groups was compared. Results There were no significant differences of HR, EF, SBP and LVEDV between the two groups before treatment（P〉 0.05）. After treatment, the HR, EF, SBP and LVEDV of two groups were significantly lower than those before treatment （P〈0.05）. And the clinical indicators of HR, EF, SBP and LVEDV in the observation group of patients were significantly better than the control group（P〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）. The total effective rate in the observation group was significantly higher than that of the control group（P〈0.05）. Conclusion The clinical use of digitalis for early acute myocardial infarction complicated with heart failure after early reperfusion（2 h） are effective, of which can significantly improve levels of HR, EF, SBP and LVEDV, and the adverse reactions are mitor. Thus it is worthy to be promoted and applied in the clinical practice.