ObjectiveTo explore the blood glucose changes in diabetes mellitus (DM) patients with acute myocardial infarction(AMI) and its influence on heart function.MethodsSeventy-three patients with AMI were divided into DM group (35 cases) with DM and non-DM group (38 cases) without DM.The blood glucose changes and the relationships with heart functon were observed in two groups.ResultsIn DM group,33 cases(94.29％,33/35) had high fasting blood glucose,whereas in the non-DM group,14 cases(36.84％,14/38) had stress hyperglycemia.The levels of fasting blood glucose and glycosylated hemoglobin in the DM group were significantly higher than those in the non-DM group [(9.7 ± 2.4) mmol/L vs.(5.8 ± 2.3) mmol/L,(10.13 ±1.95 )％ vs.(7.22 ± 1.87)％,P ＜ 0.05 ].The levels of creatine kinase isozyme MB (CK-MB) and troponin T (TnT) in the DM group were significantly higher than those in the non-DM group [ ( 217 ± 53 ) U/L vs.( 119 ± 47 ) U/L,( 6.2 ± 3.7 ) mg/L vs.( 3.4 ± 2.9 ) mg/L,P ＜ 0.05 ].The detection of left ventricular function after 4 weeks of AMI showed that left ventricular end diastolic volume (EDV) and end systolic volume (ESV) of the DM group were significantly higher and LVEF was significantly lower than those of the non-DM group [ (81.7 ± 10.8 ) ml vs.(74.9 ± 10.2 ) ml,(47.6 ± 10.7 ) ml vs.(39.8 ±12.6) ml,(41.7 ± 4.8)％ vs.(48.9 ± 8.5)％,P＜ 0.05 ].ConclusionsPatients with AMI and DM have high hyperglycemia and worse heart function.Therefore,intervention measures should be performed for these patients.

Objective: To observe the clinical effect of sodium nitroprusside and dopamine injected by micro pump for the treatment of refractory heart failure. Methods:One hundred and six cases of patients with refractory heart failure were chosen as the research object, which were cardiac functionⅢ~Ⅳlevel. All patients were treated with sodium nitroprusside and dopamine injected by micro pump. Starting dose of sodium nitroprusside was 6.25 μg/min. At same time pumping dopamine, starting dose of 2 g/kg·min, the dose was increased gradually until blood pressure dropped to 90~100 mm Hg, continuous 7~10 d, the signs and symptoms after treatment and parameters of cardiac function and adverse reactions were observed. Results: 1)In 106 cases of patients with refractory heart failure after treatment, the total effective rate 85.85%(91/106). 2)The heart rate, blood pressure, cardiothoracic ratio, left ventricular short axis reduced rate,cardiac output, each index of cardiac,indexes of left ventricular ejection fraction were improved significantly after treatment. Conclusion:The clinical effect for the treatment of refractory heart failure by using the micro pump injection of small doses of sodium nitroprusside combined dopamine would be obvious, have less adverse reactions, worthy of clinical popularization and application.

Objective To investigate the clinical efficacy and safety of lyophilized recombinant human brain natriuretic peptide(rhBNP) in the treatment of patients with congestive heart failure (CHF).Methods 120 CHF patients were randomly divided into two groups.58 cases in the observation group were given lyophilized rhBNP,and 62 patients in the control group were given sodium nitroprusside.The clinical effect,changes of echocardiographic indicators and hemodynamic parameters,adverse reactions were observed.Results After treatment,the total effective rate of the observation group was 91.37％,which was significantly higher than that of the control group(x2 =4.23,P ＜ 0.05).The LVEF and NT-proBNP levels in observation group were (59.0 ± 8.2)％ and (535.4 ± 123.8)ng/L,which had higher improvement than control group (P ＜ 0.05).The incidence rate of adverse reactions between the two groups had no significant difference (P＞ 0.05).Conclusion Lyophilized rhBNP in the treatment of CHF has significant effect,and it is worthy of clinical application and promotion.