硝酸异戊酯与硝酸甘油在老年急性心肌梗死患者急救治疗中的应用价值

杜晓峰1 ，李丽2

（1.澄城县医院，陕西 渭南，715200；2.铜川市中医医院，陕西 铜川，727000）

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摘要：

目的 探析在老年急性心肌梗死患者的急救治疗中应用硝酸甘油与硝酸异戊酯的临床价值。方法 随机将2011年10月至 2016年10月于我院接受治疗的80例老年急性心肌梗死患者分为对照组（n=40）与观察组（n=40），所有患者均接受常规急救治疗，对照组在此基础上应用硝酸甘油，观察组则在其基础上应用硝酸异戊酯，对比分析两组患者的临床治疗效果、不良反应发生情况。结果 对照组患者显效25例、有效5例、无效10例，患者的治疗总有效率为75.00%；观察组患者显效35例、有 效4例、无效1例，患者的治疗总有效率为97.50%；两组患者的治疗总有效率比较，差异具有统计学意义（P<0.05）。观察组患者出现消化道出血1例，牙龈出血者有2例；对照组患者出现消化道出血中2例，牙龈出血1例，脑出血1例。两组患者的脑出血、消化道出血及牙龈出血发生率比较，无显著差异（P>0.05）。结论 硝酸异戊酯在老年急性心肌梗死的急救治疗中较硝酸甘油具有更优异的临床治疗效果，值得临床推广。

关键词：急性心肌梗死；老年；硝酸异戊酯；硝酸甘油；急性治疗

中图分类号：R542.2文献标志码：A文章编号：2096-1413(2017)26-0022-02

Application value of isoamyl nitrate and nitroglycerin in the emergent treatment of senile patients

with acute myocardial infarction
DU Xiao-feng 1, LI Li 2
(1. Chengcheng County Hospital, Weinan 715200; 2. Tongchuan TCM Hospital, Tongchuan 727000, China)

ABSTRACT: Objective To investigate the clinical value of nitroglycerin and isosorbide nitrate in the treatment of acute myocardial infarction in senile patients. Methods From October 2011 to October 2016, 80 cases of senile patients with acute myocardial infarction treated in our hospital were randomly divided into control group (n=40) and observation group (n =40), all patients received routine treatment, on this basis, the control group was given nitroglycerin, while the observation group used isoamyl nitrate, the clinical treatment effects and complications were compared in the two groups. Results There were 25 cases of markedly effective, 5 cases of effective and 10 cases of ineffective in the control group, the total effective rate was 75.00%; while the observation group were 35 cases, 4 cases, 1 case and 97.50% respectively; the total effective rate in the observation group was significantly higher than that in the control group, the difference was statistically significant (P<0.05). There were 1 case of gastrointestinal bleeding, 2 cases of gingival bleeding in the observation group and 2 cases of gastrointestinal bleeding, 1 case of gingival bleeding, 1 case of cerebral hemorrhage in the control group, there were no significant differences in the incidence of cerebral hemorrhage, gastrointestinal bleeding and gingival bleeding between the two groups (P>0.05). Conclusion Isosorbide nitrate has better clinical effect than nitroglycerin in the treatment of acute myocardial infarction in senile patients, it is worthy of clinical promotion.

KEYWORDS: acute myocardial infarction; senile; isoamyl nitrate; nitroglycerin; emergent treatment

参考文献：
[1] 甄淑新,张勇.急性心肌梗死患者体内CRP、血脂水平变化的临床意义[J].中国实验诊断学,2014,18(10):1693-1694.
[2] 刘虹.常见心肌标志物诊断急性冠状动脉综合征的应用探讨[J].实用医技杂志,2014,21(12):1306-1307.
[3] 赵海英,常国良.硝酸甘油在老年科应用的常见问题及应对措施 [J].基层医学论坛,2014,18(6):750-751.
[4] 赵大鹏,宋殿华.重组人脑钠肽与硝酸甘油在老年急性前壁心肌梗死合并失代偿性心力衰竭治疗中的价值分析[J].中国卫生标准管理,2016,7(19):88-89.
[5] 王焕.尿激酶联合硝酸甘油治疗老年急性心肌梗死的临床疗效观察[J].亚太传统医药,2013,9(1):182.
[6] 郑云玲,张苑.老年人急性心肌梗死的饮食指导与护理[J].实用医技杂志,2012,19(3):324-325.
[7] 王江.静滴硝酸甘油对急性心肌梗死的治疗效果研究[J].中国处方药,2016,14(7):75-76.
[8] 贾敏,刘军利,盖芳,等.丹红注射液合并硝酸甘油对急性心肌梗死患者PCI治疗中无复流现象及C-反应蛋白的影响[J].河北中医药学报,2015,30(1):5-7.
[9] 侯荣.应用微量泵入硝酸甘油治疗急性心肌梗塞患者临床观察[J]. 世界最新医学信息文摘:连续型电子期刊,2015,15(83):86-87.
[10] 康忠良.硝酸异戊酯与硝酸甘油在老年急性心肌梗死患者急救治疗中的应用效果比较[J].实用心脑肺血管病杂志,2015,23(12):102-104.