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目的:探讨高血压患者发生急性心肌梗死后的血压变化及临床特征。方法:选取我院收治的120例急性心肌梗死患者,将合并高血压患者归为观察组(65例),非高血压患者归为对照组(55例)。比较2组患者发生急性心肌梗死后血压变化、临床特征和并发症的发生。结果:观察组患者无胸痛心肌梗死和心肌肥厚的发生率分别为38.4%和63.1%,均显著高于对照组(P<0.05)。发生心肌梗死后血压下降发生率高达81.5%,收缩压下降(31±12)mmHg,均显著高于对照组(P<0.05)。心功能Ⅲ级和Ⅳ级患者占比分别为18.5%和12.3%,显著高于对照组(P<0.05)。心力衰竭、室速室颤、Ⅱ度以上房室传导阻滞和死亡等并发症的发生率均显著高于对照组(P<0.05)。结论:有效控制血压,逆转心肌肥厚,增强心功能,有利于改善高血压合并急性心肌梗死患者的临床预后。
Objective: To investigate the changes of blood pressure and clinical features of hypertensive patients after acute myocardial infarction. Methods: A total of 120 acute myocardial infarction patients admitted to our hospital were enrolled. Patients with hypertension were divided into observation group (n = 65) and non-hypertensive patients as control group (n = 55). The changes of blood pressure, clinical features and complication after acute myocardial infarction in two groups were compared. Results: The incidence of chest pain-free myocardial infarction and myocardial hypertrophy in the observation group was 38.4% and 63.1%, respectively, which were significantly higher than those in the control group (P <0.05). The incidence of post-MI blood pressure was as high as 81.5% and systolic blood pressure (31 ± 12) mmHg, both significantly higher than those in the control group (P <0.05). The proportion of grade Ⅲ and Ⅳ patients with cardiac function was 18.5% and 12.3% respectively, which was significantly higher than that of the control group (P <0.05). The incidence of complications such as heart failure, ventricular fibrillation, degree of atrioventricular block and death were significantly higher than those of the control group (P <0.05). CONCLUSION: Effective control of blood pressure, reversal of cardiac hypertrophy and enhancement of cardiac function are beneficial to improve the clinical prognosis of hypertensive patients with acute myocardial infarction.