吗啡治疗急性心肌梗死并急性肺水肿临床观察

Clinical Observation of Morphine in the Treatment of Acute Myocardial Infarction Complicated with Acute Pulmonary Edema

目的探讨吗啡治疗急性心肌梗死(AMI)并急性肺水肿的临床疗效。方法选取医院2019年3月至2021年3月收治的AMI并急性肺水肿患者98例,随机分为对照组和观察组,各49例。两组患者均予再灌注介入等对症治疗以恢复心肌血流,观察组患者加用盐酸吗啡注射液缓慢(1 mg/min)静脉注射。结果治疗后,观察组总有效率为89.80%,显著高于对照组的73.47%(P<0.05);观察组患者超敏心肌肌钙蛋白I、N末端脑钠肽前体水平均显著低于对照组(P<0.05);观察组患者超氧化物歧化酶水平显著高于对照组,丙二醛水平显著低于对照组(P<0.05);观察组患者肿瘤坏死因子-α、白细胞介素1β、白细胞介素6水平均显著低于对照组(P<0.05)。观察组与对照组不良反应发生率相当(16.33%比12.24%,P>0.05)。结论吗啡治疗AMI并急性肺水肿,可改善患者的氧化应激,减轻炎性反应和心肌损伤,从而促进康复。

Objective To investigate the clinical efficacy of morphine in the treatment of acute myocardial infarction(AMI)complicated with acute pulmonary edema.Methods A total of 98 patients with AMI complicated with acute pulmonary edema admitted to the hospital from March 2019 to March 2021 were selected and randomly divided into the control group and the observation group,with 49 cases in each group.The patients in the two groups were given symptomatic treatment such as reperfusion intervention to restore myocardial blood flow,on this basis,the patients in the observation group were given the slow intravenous injection of Morphine Hydrochloride Injection(1 mg/min).Results After treatment,the total effective rate in the observation group was 89.80%,which was significantly higher than 73.47%in the control group(P<0.05).The levels of high-sensitivity cardiac troponin I(hs-cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the observation group were significantly lower than those in the control group(P<0.05).The levels of superoxide dismutase(SOD)and malondialdehyde(MDA)in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the tumor necrosis factor-α(TNF-α),interleukin(IL)-1βand IL-6 levels in the observation group were significantly lower than those in the control group(P<0.05).The incidence of adverse drug reactions in the observation group was comparable to that in the control group(16.33%vs.12.24%,P>0.05).Conclusion Morphine in the treatment of patients with AMI complicated with acute pulmonary edema can improve oxidative stress and inflammatory reactions,alleviate myocardial damage,and promote rehabilitation.