朱日进

摘要  目的：探讨老年急性心肌梗死患者应用咪哒唑仑及地西泮对镇静及睡眠质量的影响。方法：选取2017年2月至2018年7月福建省立医院ICU内接受治疗的老年急性心肌梗死重症患者72例，随机分为对照组和观察组，每组36例。对照组患者应用地西泮，观察组患者应用咪哒唑仑，比较分析2组患者镇静效果及睡眠质量。结果：观察组患者镇静评分高于对照组患者，镇静达标时间短于对照组患者，差异有统计学意义（ P <0.05）。观察组患者睡眠质量各指标评分均低于对照组患者，差异有统计学意义（ P <0.05）。结论：老年急性心肌梗死患者应用咪哒唑仑的镇静效果更好，且能够显著改善患者睡眠质量，临床应用与推荐价值极高。

关键词  老年;急性心肌梗死;咪哒唑仑;地西泮;睡眠质量

中图分类号：R541.4 文献标识码：A  doi： 10.3969/j.issn.2095-7130.2018.10.005

Effects of Diazepam and Midazolam on Sedation and Sleep Quality  in Elderly Patients with Acute Myocardial Infarction in ICU

Zhu Rijin

（Institute of Fujian Emergency Medicine/ Shengli Clinical College of Fujian Medical University/Department  of Emergency，Fujian Provincial Hospital/ Fujian Provincial Emergency Centre，Fuzhou，350000）

Abstract Objective： To investigate the effects of midazolam and diazepam on sedation and sleep quality in elderly patients with acute myocardial infarction. Methods： A total of 72 elderly patients with acute myocardial infarction who underwent treatment in our hospital from February 2017 to July 2018 were randomly selected as the reference group（ n =36）and the experimental group（ n =36）.The patients in the reference group were treated with diazepam.In the experimental group，midazolam was used to compare the sedative effect and sleep quality of the two groups. Results： In the experimental group，the sedation score was higher than that in the reference group.The sedation time was shorter than that in the reference group，and the difference was significant（ P <0.05）.The scores of sleep quality of the experimental group were lower than those of the reference group，and the difference was significant（ P <0.05）. Conclusion： The use of midazolam in elderly patients with acute myocardial infarction has a better sedative effect and can significantly improve the quality of sleep.The clinical application and recommendation value are extremely high.

Key Words  Old age;Acute myocardial infarction;Midazolam;Diazepam;Sleep quality

急性心肌梗死是一種发病急、病情进展快、病死率高的危重急症，临床中ST段抬高型心肌梗死较为常见[1]。在临床治疗中，特别是ICU内经常需要酌情使用催眠镇静剂。地西泮是一种常用催眠镇静剂，但老年患者应用后，易出现白天思睡、纳差、乏力、情绪低落等情况，甚至产生严重抑郁状态。为此，一定要积极探索一种疗效更加确切的催眠镇静方法。我院ICU内接受治疗的老年急性心肌梗死危重症患者72例予以分组研究，分析咪哒唑仑的催眠镇静效果，现将结果报道如下。

1 资料与方法

1.1 一般资料 选取2017年2月至2018年7月我院ICU内接受治疗的老年急性心肌梗死患者72例，随机分为对照组和观察组，每组36例。对照组中男19例，女17例;年龄62～81岁，平均年龄（71.2±6.3）岁;梗死部位：前壁20例，正后壁2例，下壁14例。观察组中男21例，女15例;年龄61～83岁，平均年龄（72.0±6.6）岁;梗死部位：前壁21例，正后壁2例，下壁13例。2组患者的基线资料比较，差异无统计学意义（ P >0.05），具有可比性。