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目的探讨地尔硫治疗急性非ST段抬高型心肌梗死(ANSTEMI)合并心力衰竭的疗效与安全性。方法将80例ANSTEMI且合并心力衰竭的患者随机分为地尔硫组40例和对照组40例,对照组给予常规治疗,地尔硫组在常规治疗的基础上静脉给予地尔硫治疗,比较两组患者心绞痛缓解、ST段回升、心功能改善及不良反应发生情况。结果地尔硫组心绞痛缓解程度、缺血性ST段改善程度均优于对照组(P<0.05);治疗后两组患者SBP、DBP、HR均较治疗前下降(P<0.05),且治疗后地尔硫组HR明显低于对照组(P<0.05),但两组治疗后SBP、DBP比较,差异无统计学意义(P>0.05);治疗后两组氨基末端脑钠肽前体(NT-pro BNP)均较治疗前下降(P<0.05),左室射血分数(LVEF)均较前升高(P<0.05),但治疗后两组NT-pro BNP、LVEF比较,差异无统计学意义(P>0.05);两组治疗前后左室舒张末期内径比较,差异无统计学意义(P>0.05)。两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论静脉应用地尔硫可显著缓解ANSTEMI合并心力衰竭患者的心绞痛症状而不加重心力衰竭,疗效显著、安全可靠。
Objective To investigate the efficacy and safety of diltiazem in the treatment of acute non-ST-segment elevation myocardial infarction (ANSTEMI) combined with heart failure. Methods Eighty patients with ANSTEMI complicated with heart failure were randomly divided into Dulsed group (40 cases) and control group (40 cases). The control group was given routine treatment. Diltiazem group was given intravenous Diltiazem Treatment, angina pectoris relief, ST segment recovery, cardiac function improvement and adverse reactions were compared between the two groups. Results The degree of improvement of angina pectoris and the improvement of ischemic ST segment in diltiazem group were better than those in control group (P <0.05). The SBP, DBP and HR of two groups decreased after treatment (P <0.05), and After treatment, the HR in diltiazem group was significantly lower than that in the control group (P <0.05), but there was no significant difference in SBP and DBP between the two groups after treatment (P> 0.05) (NT-pro BNP) were lower than those before treatment (P <0.05) and left ventricular ejection fraction (LVEF) were higher than before (P <0.05) There was no significant difference between the two groups (P> 0.05). Before and after treatment, left ventricular end-diastolic diameter had no significant difference (P> 0.05). Adverse reactions between the two groups, the difference was not statistically significant (P> 0.05). Conclusion Intravenous diltiazem can significantly relieve angina pectoris without worsening heart failure in patients with ANSTEMI complicated with heart failure, and has a significant effect and is safe and reliable.