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目的探讨卡维地洛联合螺内酯治疗心肌梗死后心力衰竭患者的临床疗效。方法选取2012年12月至2015年3月中国医科大学附属一院鞍山医院收治的138例心肌梗死后心力衰竭患者作为研究对象,按随机数字表法将其分为观察组和对照组,各69例。两组患者入院后均给予心内科常规治疗,同时对照组患者口服螺内酯,观察组患者在对照组基础上采用卡维地洛进行治疗,比较两组患者心功能改善情况、治疗前后左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)水平及再住院率、病死率。结果观察组患者美国纽约心脏病协会(NYHA)分级I级比例明显高于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的LVEF明显高于对照组,LVESD、LVEDD水平均明显低于对照组,差异均有统计学意义(均P<0.05);观察组患者的再住院率、病死率均明显低于对照组,差异均有统计学意义(χ~2=6.2381、3.1243,P<0.05)。结论卡维地洛联合螺内酯治疗心肌梗死后心力衰竭临床效果显著,可有效改善患者心脏功能,降低病死率和再住院率。
Objective To investigate the clinical efficacy of carvedilol combined with spironolactone in the treatment of patients with heart failure after myocardial infarction. Methods From December 2012 to March 2015, 138 cases of post-MI heart failure patients admitted to Anshan Hospital, the First Affiliated Hospital of China Medical University were divided into observation group and control group according to random number table example. Both groups were given routine cardiology treatment after admission, while patients in the control group received oral spironolactone. The patients in the observation group were treated with carvedilol on the basis of the control group. The improvement of cardiac function was compared between the two groups. Before and after treatment, left ventricular ejection (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD) and rehospitalization rate and mortality. Results In the observation group, NYHA grade I was significantly higher than that of the control group (P <0.05). After treatment, the LVEF in the observation group was significantly higher than that in the control group. LVESD, LVEDD (All P <0.05). The rehospitalization rate and mortality in the observation group were significantly lower than those in the control group (χ ~ 2 = 6.2381 , 3.1243, P <0.05). Conclusion Carvedilol combined with spironolactone treatment of heart failure after myocardial infarction significant clinical effect, which can effectively improve the patient’s cardiac function, reduce mortality and rehospitalization rate.