早期利尿预防急性前壁心肌梗死后心力衰竭的疗效分析

Efficacy Analysis of Early Diuresis in Preventing Heart Failure After Acute Anterior Wall Myocardial Infarction

目的:对急性前壁心肌梗死患者应用早期利尿剂治疗的临床价值进行讨论。方法:回顾分析2019年1月-2021年12月南华大学附属长沙中心医院心血管内科收治的急性前壁心肌梗死患者68例,随机分为对照组与研究组,入院后给予标准化抗缺血治疗或联合使用早期利尿方案。比较两组治疗效果、心功能指标、心脏结构指标、B型钠酸肽与不良反应发生率。结果:研究组患者治疗有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,各项心脏功能指标比较,研究组左心室行张末期容量、左心室收缩末期容量、心搏出量、左心室射血分的均大于对照组,差异有统计学意义(P<0.05)。治疗后,研究组左心室舒张末期内径、左心室收缩末期内径、左心室右壁厚度和室间隔厚度小于对照组,差异有统计意义(P<0.05)。治疗后,研究组B型钠酸肽低于对照组,差异有统计学意义(P<0.05);研究组临床不良反应总发生率低于对照组,差异无统计学意义(P>0.05)。结论:使用早期利尿治疗急性前壁心肌梗死能够较好的改善患者心功能,且不良反应较少,建议在临床研究中推广使用。

Objective:To discuss the clinical value of early diuretic therapy in patients with acute anterior wall myocardial infarc⁃tion.Methods:A total of 68 patients with acute anterior wall myocardial infarction admitted to Department of Cardiology,Chang⁃sha Central Hospital,University of South China from January 2019 to December 2021 were retrospectively analyzed.They were randomly divided into control group and study group,who were given standardized anti-ischemia therapy or combined early di⁃uretic regimen after admission.The therapeutic effect,cardiac function index,cardiac structure index,B-type natriuretic peptide and incidence of adverse reactions were compared between the two groups.Results:The effective rate of patients in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,various cardiac function indexes were compared,the left ventricular end-diastolic volume,left ventricular end-systolic volume,cardiac output,and left ventricular ejection fraction of the study group were all higher than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the left ventricular end-diastolic diameter,left ventricular end-systolic di⁃ameter,left ventricular right wall thickness and interventricular septum thickness in the study group were smaller than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the B-type natriuretic peptide in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of clinical adverse reactions in the study group was lower than that in the control group,and the difference was not statistically sig⁃nificant(P>0.05).Conclusion:The use of early diuresis treatment of acute anterior wall myocardial infarction can better improve the cardiac function of patients with less adverse reactions,and it is recommended to promote the use in clinical research.