氯沙坦和依那普利对急性心肌梗塞后左心室重塑的治疗效应  

The Effects of Angiotensin Ⅱ Subtype-1 Receptor Antagonist Losartan and Angiotensin Converting Enzyme Inhibitor Enapril on Left Ventricular Remodeling after Acute Myocardial Infarction

作　　者：张宝娓[1] 王晓阳[2] 何萍[1] 李建平[1] 丁文惠[1] 

机构地区：[1]北京医科大学第一医院心内科,北京市100034 [2]河南省洛阳市中心医院

出　　处：《中国循环杂志》2000年第6期328-330,共3页Chinese Circulation Journal

摘　　要：目的 :了解氯沙坦及依那普利对急性心肌梗塞 (AMI)患者左心室重塑的治疗效应。　　方法 :急性心肌梗塞患者 6 3例 ,按治疗不同分为 3组 :氯沙坦组 (n=19)、依那普利组 (n=2 3)和对照组 (n=2 1) ,采用超声心动图测量入院后第 1、5、14天以及 3、6个月左心室舒张末容积指数 (L VEDVI)、左心室收缩末容积指数(L VESVI)及左心室射血分数 (L VEF)的变化 ,并进行临床观察。　　结果 :对照组与入院基础值比 ,在 14天及 3个月时 L VEDVI及 L VESVI增加具有统计学显著性 (P<0 .0 5 )。氯沙坦组及依那普利组 ,与对照组比较 14天及 3个月时 L VEDVI降低具统计学显著性 (P<0 .0 5 ) ;L VESVI降低 ,14天时具统计学显著性 (P<0 .0 5 )。依那普利组咳嗽发生率 2 5 % ,而氯沙坦组无一例咳嗽发生。　　结论 :氯沙坦及依那普利对 AMI患者具有相似的抗左心室重塑效应 。Objective:To study the effects of angiotensin Ⅱ subtype 1(AT1) receptor antagonist losartan and angiotensin converting enzyme inhibitor(ACEI) enapril on left ventricular remodeling(LVRM)after acute myocardial infarction. Methods:Sixty three patients with acute myocardial infarction (AMI) were divided into three groups randomly.Left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI)and left ventricular ejection fraction(LVEF)were measured by echocardiogram on the day of 1,5 and 14 as well as month of 3 and 6.Side effects were recorded. Results:In control group,LVEDVI and LVESVI increased throughout 6 months with significant increase on day 14 and month 3.LVEF decreased.Losartan and enapril equally prevented the increase of LVEDVI which was significant on day 14 and month 3.LVESVI was also decreased by the treatment of two drugs which was significant on day 14.There was no medicine related cough in losartan group while the incidence of cough in enapril group was 25%. Conclusion:Losartan and enapril have similar anti LVRM effect,but losartan is more tolerable.

关 键 词：急性心肌梗塞 氯沙坦 依那普利 左心室重塑 治疗 

分 类 号：R542.220.5[医药卫生—心血管疾病] R972[医药卫生—内科学]