心肌梗死患者抗醛固酮治疗后心功能变化的多普勒组织成像研究  

Cardiac Function in Patients with Myocardial Infarction Treated with Spironolactone:A Doppler Tissue Imaging Study

作　　者：刘长福[1] 霍霄鲲[1] 杨庭树[1] 智光[1] 徐勇[1] 韩宝石[1] 

机构地区：[1]中国人民解放军总医院心血管内科,北京市100853

出　　处：《中国康复理论与实践》2010年第5期413-414,共2页Chinese Journal of Rehabilitation Theory and Practice

基　　金：军队"十五"医药卫生科研基金课题(01Z036)

摘　　要：目的应用多普勒组织成像(DTI)技术评价心肌梗死患者抗醛固酮治疗前后心功能的动态变化。方法 130例确诊心肌梗死患者分为螺内酯组(常规治疗+螺内酯)61例与对照组(常规治疗)69例,在入选时,治疗6个月、12个月后行DTI及常规超声心动图检查。结果治疗6个月后,螺内酯组收缩期主峰s波速度的平均值(s-)较治疗前增加(P<0.05),左室射血分数(LVEF)有增加趋势但无统计学意义。治疗12个月后,螺内酯组-s增加(P<0.05),LVEF也有改善(P<0.05)。对照组患者治疗6个月和12个月后,s-、LVEF均无显著性差异。各组舒张早期与晚期主峰速度比(e/a)治疗前后无显著性差异(P>0.05)。结论常规治疗联合螺内酯可改善心肌梗死患者6个月和12个月收缩功能,但未改善舒张功能。Objective To study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction.Methods 130 patients with myocardial infarction were divided into anti-aldosterone group （spironolactone 20～40 mg/d ＋ enalapril 10～20 mg/day,n=61） and control group （enalapril 10～20 mg/d,n=69）.The echocardiogram and Doppler tissue imaging （DTI） were performed at enrolling time,and 6,12 months after treatment.Results In the anti-aldosterone group,the average mitral systolic wave （s） was significantly increased 6 months after treatment （P0.05） to the enrolling time.LVEF and LVEDD improved 12 months after treatment （P0.05）.In the control group,the average mitral systolic wave,LVEDD and LVEF did not significantly improve （P0.05）.Ratio of peak early to late diastolic filling velocity （e/a） was no significantly different between the anti-aldosterone group and the control group.Conclusion The combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months,but cannot to the diastolic function.

关 键 词：心肌梗死 醛固酮拮抗剂 多普勒组织成像 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]