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目的探讨早期心率控制对急性心肌梗死(AMI)患者近期预后的影响。方法选择本院2011年8月~2013年7月收治的256例起病24 h内入院的AMI患者。所有患者均常规每日应用比索洛尔片,不需调整剂量就达目标心率(55~65次/min)者为A组,未达目标心率者再随机分组于入院后第1天(B组)、第3天(C组)、第7天(D组),调整比索洛尔用量至目标心率。观察其住院期间及1个月内梗死后心绞痛、再发心肌梗死、恶性心律失常和心原性休克的发生情况。结果 A组、B组和C组患者的心梗后心绞痛、再发心肌梗死、恶性心律失常和心原性休克的发生率均显著低于D组(P<0.05)。结论起病24 h内入院的AMI患者入院后心率早期(3 d内)控制达标(55~65次/min)可明显改善患者的近期预后,对临床工作具有十分重要的指导意义。
Objective To investigate the effect of early heart rate control on the short-term prognosis of patients with acute myocardial infarction (AMI). Methods A total of 256 patients admitted to our hospital within 24 hours from August 2011 to July 2013 were enrolled in this study. All patients were routinely daily application of bisoprolol tablets, without adjusting the dose reached the target heart rate (55 ~ 65 beats / min) were in group A, those who did not reach the target heart rate were randomly assigned to the first day after admission (group B ), Day 3 (group C), and day 7 (group D), the amount of bisoprolol was adjusted to the target heart rate. Observe the incidence of myocardial infarction, malignant arrhythmia and cardiogenic shock during hospitalization and within 1 month after angina infarction. Results The incidences of post-myocardial infarction, recurrent myocardial infarction, malignant arrhythmia and cardiogenic shock in group A, group B and group C were significantly lower than those in group D (P <0.05). Conclusions Controlled admission of AMI patients within 24 hours after onset within 3 days (55 ~ 65 beats / min) can significantly improve the short-term prognosis of patients with AMI, which is of great guiding significance for clinical work.