螺内酯对急性心肌梗死患者左心室重塑的影响  

Effect of spironolactone on the left ventricular remodeling in patients with acute myocardial infarction

作　　者：孙琪[1] 陈念[1] 闫寿敬[1] 刘丽辉[1] 徐泽昌[1] 张桂珍[1] 李鲁光[1] 

机构地区：[1]北京军区总医院心内科,北京100700

出　　处：《中国综合临床》2005年第9期771-773,共3页Clinical Medicine of China

摘　　要：目的探讨应用小剂量螺内酯对急性心肌梗死(AMI)患者左心室重塑的影响。方法AMI患者84例,按梗死部位分为前壁心肌梗死组(43例)和下壁心肌梗死组(41例),两组患者再随机分为螺内酯治疗组和常规治疗组,于发病后1周、3个月和6个月行二维超声心动图检查,观测左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)和左心室收缩末期容积指数(LVESVI)。结果前壁心肌梗死组:6个月时螺内酯组LVEDD、LVESD、LVEDVI和LVESVI与对照组相比明显下降(P<0.05),而LVEF升高差异有显著性(P<0.05);下壁心肌梗死组:两组在治疗6个月时上述指标差异均无显著性(P>0.05)。结论常规治疗的基础上联合应用小剂量螺内酯,可进一步防止前壁AMI患者左心室重塑的发生,对下壁AMI患者未见明显差异。Objective To evaluate the effect of spironolactone on the left ventricular remodeling（LVRM）in acute myocardial infarction （ AMI ） patients. Methods 84 AMI cases were randomly divided into anterior MI group（ n = 43 ） and inferior MI group（ n = 41 ）. Each group was randomly subdivided into spironolactone intervention group and routine treatment group. All patients were examined with two-dimensional echocardiography. Left ventricular end-diastolic diameter （ LVEDD ） , left ventricular end-systolic diameter （ LVESD ） , left ventricular end-diastolic volume index （ LVEDVI ） , left ventricular end-systolic volume index （ LVESVI ） and ejection fraction （ LVEF ） were measured on the 1st week,3rcl,and 6th month. Results After 6-month intervention,the spironolactone subgroup in anterior MI group had a lowered LVEDD, LVESD, LVEDVI and LVESVI compared with control group （ P 〈 0.05 ）.LVEF was of significant difference between groups, while there was no significant difference in LVEDD, LVESD,LVESVI and LVEF between subgroups of inferior MI group 6 months after intervention （ P 〉 0.05 ）. ConclusionThose findings indicate that in patients with anterior AMI，spironolactone combined with routine treatment may prevent left ventricular remodeling,which exerts no significant difference in patients with inferior AMI.

关 键 词：急性心肌梗死 螺内酯 左心室重塑 治疗 

分 类 号：R542.22[医药卫生—心血管疾病]