口服卡托普利对肺心病患者心室功能的影响  

Evaluation of the effect of oral captopril on ventricular function and conduction with radionuclide ventriculography in patients with chronic cor pulmonale

作　　者：郑柏洁[1] 张金谷[1] 张洪玉[2] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院核医学科,100020 [2]北京市呼吸疾病研究所

出　　处：《中华内科杂志》2000年第1期17-19,共3页Chinese Journal of Internal Medicine

摘　　要：目的　动态观察卡托普利 (CPT)对肺心病患者心脏功能及传导的影响。方法　对 2 5例正常人及 2 3例慢性肺心病患者进行门电路核素心室显像 ,并对 2 3例肺心病患者动态观察口服CPT前后心脏功能和传导的变化。结果　肺心病患者口服CPT前右室射血分数 (RVEF)和右室最大射血率 (RVMER)均低于正常人 (P <0 .0 0 5 )。口服CPT 1h后RVEF从 (3 1.92± 7.5 4 ) %上升至 (3 7.4 4±8 62 ) % ,P <0 .0 5。RVMER从 (1.62± 0 .63 )EDV/S上升至 (2 .2 1± 1.18)EDV/S ,P <0 .0 5。右室最大充盈率和左室射血分数无明显变化。心率 (HR)从 (10 2 .3 9± 2 1.85 )次 /分下降至 (96.92± 2 1.81)次 /分 ,P <0 .0 5。HR与RVEF、RVMER在口服CPT前后均无明显相关。肺心病患者口服CPT前心室相角程较正常人明显增宽 ,相位色阶升高 ,相位电影示右室传导减慢或阻滞 (9/ 2 3 )及双室传导减慢(6/ 2 3 ) ,口服CPT后相位分析未见有意义的变化。结论　CPT可降低肺心病患者右室后负荷 ,增加右室射血 ,改善右室功能 ,以改善右室收缩功能更为明显 ,对治疗肺动脉高压和慢性肺心病是一种有效的药物。Objective To evaluate the effect of ventricular function and conduction before and after oral captopril in patients with chronic cor pulmonale(CCP). Method 23 patients with CCP and 25 normal subjects were examined. Ventricular function and conduction changes were observed dynamically in the patients before and after oral captopril with radionuclide ventriculography. Results In the patient group before oral captopril right ventricular ejection fraction (RVEF) and right ventricular maximum ejection rate (RVMER) were lower than those in the control group ( P <0.005). One hour after oral captopril RVEF and RVMER increased from (31.92±7 54)% to (37.44±8.62)% ( P <0.05) and (1.62±0.63) EDV/S to (2.21±1.18)EDV/S ( P <0.05). Right ventricular maximun filling rate and left ventricular ejection fraction did not change signifieantly . Heart rate (HR) decreased from (102.39±21.85) beat/min to (96.92±21.81) beat/min ( P <0 05). HR was not related with RVEF and RVMER. Phase analysis showed significant delay in the patient group as compared with the control group.9 cases showed slow right ventricular conduction ; 6 cases showed both left and right slow ventricular conduction .However , there was no marked phasic change after oral captopril. Conclusions Captopril can decrease right ventricular after load ,increase right ventricular ejection and improve right ventricular function. It is an effective drug for treatment of pulmonary artery hypertension and CCP.

关 键 词：肺心病 卡托普利 心室功能 影响 

分 类 号：R541.5[医药卫生—心血管疾病] R972.4[医药卫生—内科学]