咪达唑仑用于老年急性心肌梗死患者催眠镇静的疗效分析

目的评价咪达唑仑用于老年心肌梗死患者急性期镇静的效果及副作用。方法42例大于60岁急性心肌梗死患者入院后随机分成2组，各21例，分剐服用咪达唑仑（中午服用3．75～7．5mg，睡前服用7．5～15mg）和地西泮（白天分两次服用2．5～5．0mg，睡前服用5．0～7．5mg），使患者镇静程度达到ramsary评分2-3分。每6小时1次记录镇静程度，达到镇静要求的记1分，未达要求者记0分；发病7-10d采用临床精神卫生症状自评量表（SCL-90）评估。结果咪达唑仑组与地西泮组分别于（0．42±0．25）h和（1．11±0．46）h开始达到镇静要求，两者差异有统计学意义（t=3．22，P〈0．05）。咪达唑仑组镇静记分为（24．63±5．31）分，地西泮组为（18．214±4．52）分，前者明显大于后者（t=2．54，P〈0．05）。患者SCL-90评估中，咪达唑仑组的躯体化、强迫、抑郁、焦虑、恐怖和精神病性因子评分明显低于地西泮组（t分别=2．07、2．12、2．23、2．07、2．15、2．17，P均〈0．05）。结论咪达唑仑用于老年人心肌梗死的镇静催眠比地西泮起效更快，嗜睡、乏力、纳差、抑郁、焦虑症状明显少于地西泮，较适合于老年心肌梗死患者。

Hypnotic sedative comparison of midazolam and diazepam for elderly patients with acute myocardial infarction

Objective To evaluate the effects of different sedative drugs for elderly patients with acute myocardial infarction. Methods Forty two cases more than 60-year-old with acute myocardial infarction were randomly divided into 2 groups. 21 cases took midazolam （3.75～7.5 mg taken at noon, 7.5～15 mg bedtime） and the others took .diazepam （2.5～5.0 mg daytime twice, 5.0～7.5 mg bedtime）.The degree of sedation in patients with ramsary score reached 2～3. Every six hours, sedative points were recorded.At the 7～10 days of onset, the mental health symptom was assessed by checklist （SCL-90）. Results Midazolam group and diazepam group began to reach sedation at （0.42 ± 0.25） hrs and （1.11 ± 0.46） hrs （t=3.22,P 〈0.05）. Sedation scores were （24.63 ± 5.31） and （18.21 ± 4.52） （t=2.54,P〈0.05）. SCL-90 assessment of the body, force, depression, anxiety, terror and psychosis scores in the midazolam group were significantly lower than that of diazepam group （t = 2.07,2.12,2.23, 2.07,2.15,2.17,P 〈0.05）.Conclusions Midazolam is more effective than diazepam and suitable for older patients with myocardial infarction.