阿司匹林联合血管紧张素转换酶抑制剂改善急性心肌梗塞预后  

Aspirin and ACE inhibitors together improve prognosis of acute myocardial infarction

作　　者：肖骅[1] 周建庆[1] 葛世俊[1] 赵维庆[1] 高丛光[1] 陈文采[1] 柳俊平[1] 沈文均[1] 周军波[1] 

机构地区：[1]宁波市医疗中心李惠利医院,浙江宁波315040

出　　处：《心血管康复医学杂志》2006年第4期365-367,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：研究阿司匹林和血管紧张素转换酶抑制剂（ACEI）联合使用对急性心肌梗塞（AMI）患者病死率的影响。方法：对1994年1月至2005年6月期间267例AMI病人进行随访（平均605天）以确定转归，回顾性分析AMI病人有关病史及治疗措施，进行Cox多因素生存分析及卡方分析。结果：阿司匹林（OR=0．46，P〈0．05）、ACEI（0R=0．42，P〈0．01）与AMI病死率独立相关。未用阿司匹林及ACEI组、单用阿司匹林组、单用ACEI组病死率分别是68．8％、32．5％、35．3％，阿司匹林与ACEI合用组病死率14．8％，与前三组有显著差异（P〈0．05～〈0．0001）。结论：阿司匹林与ACEI合用更能降低AMI病死率。Objective： This study was to evaluate the clinical effects of angiotensin converting enzyme inhibitors （ACEI） with aspirin treatment for acute myocardial infarction （AMI）. Methods： Participants included 267 patients discharged with a diagnosis of AMI between January 1994 and September 2004. The patients were followed up with average 605 days. Muhivariable Cox regression analyses were performed to examine the relation among mortality and aspirin, ACEI treatment after AMI while controlling for baseline characteristics and early therapeutic interventions. Chisquared analyses were performed to compare the effects of aspirin, ACEI, and ACEI with aspirin treatment. Results ： A significant association among aspirin （OR = 0. 46, P〈0.05）, ACEI （OR = 0. 42, P〈0. 01 ） treatment initiated in hospital after AMI and mortality existed in muhivariable-adjusted regression analyses controlling for potentially confounding demographic, clinical factors and therapeutic interventions. Mortality of patients treated with aspirin and ACEI was less than that of treated alone with aspirin or ACEI during average 605 day follow-up （14.8% vs. 32.5%, 35.3%, P〈0. 05～〈0. 0001）. Conclusion： ACEI combine with aspirin treatment significantly reduced mortality in AMI patients.

关 键 词：心肌梗塞 阿司匹林 血管紧张素转换酶抑制剂 

分 类 号：R542.22[医药卫生—心血管疾病]