硝酸甘油联合氨酰心安治疗急性心肌梗死合并左心衰的临床观察

目的 观察硝酸甘油联合氨酰心安治疗急性心肌梗死（AMI）合并左心衰的临床疗效.方法 选取我院2010年1月-2013年1月AMI合并左心衰患者60例,按照随机数字表法分为对照组和观察组,每组30例.对照组在常规治疗基础上给予硝酸甘油静脉泵入;观察组在常规治疗基础上加用硝酸甘油和氨酰心安.5～7d为1疗程,1疗程后,观察两组患者临床症状及体征改善情况,比较两组临床疗效.结果 对照组患者显效15例,有效9例,无效6例,有效率80.0%,治疗过程中出现低血压2例,头痛1例,窦性心动过速3例;观察组患者显效22例,有效6例,无效2例,有效率93.33%,治疗过程中出现低血压1例,头痛2例,不良反应症状随药物停用而逐渐缓解.观察组临床治疗有效率高于对照组,差异有统计学意义（P＜0.05）.结论 对AMI合并左心衰患者采取小剂量的硝酸甘油联合氨酰心安进行治疗,临床疗效满意,安全性较好,是治疗AMI合并左心衰的理想方案.

Clinical Observation of Left Heart Failure of Nitroglycerin Combined with Atenolol in Treatment of AMI

Objective To observe the effect of nitroglycerin combined with atenolol in treatment of acute myocardial infarction （AMI） complicated with left heart failure clinical effect. Methods in our hospital from 2010 January to 2013January AMI patients with left heart failure in 60 cases, randomly divided into control group and observation group, 30 cases each group. The control group on the basis of conventional therapy, given nitroglycerin infusion pump ; observation group on the basis of conventional therapy plus nitroglycerin and atenolol. 5 -7d to 1 course of treatment, after 1 courses of treatment, two groups were observed in patients with clinical symptoms andsigns, clinical efficacy was compared between the two groups. Results in the control group 15 cases, effective 9 cases, invalid 6 cases, efficiency of 80% , in the treatment of hypotension in 2 cases, 1 cases of headache, sinusheartbeat tachycardia in 3 cases ; the observation group 22 eases, effective 6 cases, invalid 2 cases, efficiency of 93.33 % , in the treatment of low blood pressure of 1 cases, 2 cases of headache, adverse reactions with symptoms of drug withdrawal and gradually ease. To observe the clinical effective rate of treatment group was higher than that in the control group, the difference was statistically significant （ P 〈 0.05 ）. Conclusion AMI combined with left heart failure patients take nitroglycerin combined with atenolol small dose of treatment, the clinical effect is satisfactory, safety is good, is the ideal solu- tion for treatment of AMI complicated with left heart failure.