【摘要】 目的探讨急性心肌梗死(acute myocardial infarction,AMI)合并高血压患者的临床特点。方法选择90例AMI患者分A组(伴高血压史)、B组(无高血压史)。观察AMI前后血压变化、LVH情况,AMI后2周内UCG测定LVEF、E/A比值、泵功能,血清心肌酶峰CPK、CK-MB测定,血浆AngⅡ、β-EP和CGRP水平的测定,及梗死后心脏事件等。结果 A组血压下降明显,并与基础血压、LVH、泵功能有关;A组发生AMI后AngⅡ、8-EP、降钙素基因相关肽(CGRP)及CPK、CK～MB水平均高于B组;血压下降者LVEF及E/A显著低于血压无下降者,A组泵功能Ⅲ～Ⅳ级发生率高于B组,心脏事件及死亡率也高于B组。结论高血压是冠心病的重要危险因素,高血压发生AMI后71.1%血压下降,这与心功能恶化、LVH、梗死面积大以及血浆AngⅡ、β-EP、CGRP水平更高有关。更多还原

【Abstract】 Objective To investigate the clinical characters of patients with acute myocardial infarction(AMI) and hypertension.Methods 90 AMI patients are divided into two groups:group A(AMI with hypertension ) and group B(AMI without hypertension ).The experiment is designed to study the pre - AMI blood pressure and the post - AMI blood pressure、the fluctuation for LVH,the ratio of LVEF and E/A calculated by UGG within two weeks after AMI,the pump function,the recording for myocardial enzymes CPK and CK - MB,the recording for blood AngⅡ,β- EP and CGRP level and the cardiac events after myocardial infarction.Results There is an obvious decrease in the blood pressure for A group;and it is associated with the basic blood pressure,LVH and the pump function.After the AMI,the AngⅡ,β- EP,calcitonin gene、CRGP,CPK, CK - MB level for A group are higher than that of B group counterparts.Those blood pressure decrease have profound lower LVEF and E/A than their counterparts whose blood pressure maintain the same level.The incidence rate regarding the pump functionⅢ-Ⅳfor A group is higher than B group.Meanwhile,the myocardial infarction morbidity is higher than B group. Conclusion The high risk for the patients having hypertension and coronary artery disease.71.1%patients recorded as having hypertension will have a decreased blood pressure after AMI.This if linked with the heart deterioration,LVH,large area of infarction,as well as the higher level of blood AngⅡ,β- EP,CGRP.更多还原