吗啡与哌替啶在急性下壁心肌梗死患者中的应用比较

目的观察吗啡与哌替啶在急性下壁心肌梗死患者中的临床疗效。方法将我院及泸州医学院附属医院心内科2009年3月～2011年3月收治的93例急性下壁心肌梗死患者随机分成对照组(31例)、吗啡组(31例)、哌替啶组(31例)。吗啡组患者入院时给予吗啡5mg皮下注射,哌替啶组患者入院时给予哌替啶50mg肌肉注射,对照组予以生理盐水注射。比较3组患者的治疗效果及48h内出现的心律失常情况。结果 3组患者在发病后心肌钙蛋白T(cTnT)水平均呈现逐渐升高趋势,药物组与对照组比较差异有统计学意义,P<0.05,而吗啡组与哌替啶组无差异。3组患者在48h内心律失常发生率比较差异有统计学意义,P<0.05。对照组窦性心动过缓发生率最高,吗啡组和哌替啶组发生窦性心动过缓较对照组低,均差异有统计学意义,P<0.05;吗啡组发生窦性心动过缓较哌替啶组高,两组比较差异有统计学意义P<0.05。结论急性下壁心肌梗死患者应用吗啡和哌替啶均可减少窦性心动过缓的发生,但哌替啶减少窦性心动过缓效果优于吗啡。

Objective to study and contrast the clinical application efficacy of morphine and pethidine in patients with acute inferior myocardial infarction

Objective Investigate the clinical application efficacy of morphine and pethidine in patients with acute inferior myocardial infarction.Methods 93 cases of acute inferior myocardial infarction were randomly divided into control group(31 cases),morphine group(31 cases),pethidine group(31 cases).The morphine group given 5mg morphine by hypodermic injection after Admission,the pethidine group given 50mg pethidine by intramuscular injection,the control group given physiological saline.To compare the efference of treatment and record the occurrence of cardiac arrhythmia.Results The plasma level of cTnT were showing a gradual trend.In comparison with the control group,the level of cTnT in experimental group were significant negative correlation(P<0.05),between the drug group,there was not different significantly.There were significantly incidence rate of cardiac arrythmia in this three groups(P<0.05).Sinus bradycardia is the highest incidence in patients with acute inferior.There was big difference between group morphine and group pethidine.Conclusion The general effect in using pethidine is much better than morphine in patients with acute inferior.The arrhythmogenic side effects is mutch lower than morphine.