厄贝沙坦与依那普利治疗急性心肌梗死患者的疗效比较  

Comparison of irbesartan and enalapril for treating patients with acute myocardial infarction

作　　者：段班燕[1] 党书毅[1] 周明[1] 谢建[1] 李军[1] 许海军[1] 王俊峰[1] 

机构地区：[1]湖北医药学院附属十堰市太和医院心内科,442000

出　　处：《疑难病杂志》2013年第11期832-834,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察厄贝沙坦与依那普利对急性心肌梗死患者疗效的比较。方法将86例急性心肌梗死患者随机分为厄贝沙坦组(40例)与依那普利组(46例)。2组在常规治疗基础上分别加用厄贝沙坦与依那普利,疗程2个月并随访6个月。记录2组心脏超声、血压、心率、血脂、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)、基质金属蛋白酶2、9(MMP-2,9)以及不良心血管事件。结果与治疗第1天比较,治疗第60天2组TC、HDL-C、LDL-C、hs-CRP及BNP均有较大改善(P<0.05),厄贝沙坦组LVEF及依那普利组EDVI升高(P<0.05);2组MMP-2、MMP-9均下降,且厄贝沙坦组MMP-2、9活性较依那普利组更低(P<0.05),余各指标未见差异(P>0.05);随访6个月,2组患者心血管事件发生率未见差异(P>0.05)。结论厄贝沙坦与依那普利对急性心肌梗死均有较好改善作用;厄贝沙坦的疗效不劣于依那普利,其可作为ACEI的替代药物。Objective To investigate the effects of irbesartan and enalapril on patients with acute myocardial infarction（AMI）.Methods 86 patients with AMI were randomly divided into the irbesartan group（n = 40） and the enalapril group（n =46）.Each group was given traditional treatment and related medicine（irbesartan or enalapril） for 2 months and followed up for 6 months.Conventional index,like：Blood pressure,heart rate,lipid,ultrasound,high sensitive C reactive protein（hs-CRP）,brain natriuretic peptide（BNP）,and matrix metalloproteinase-2,-9（MMP-2,-9） and adverse cardiovascular events were recorded.Results After treatment,the improvement for lipid,hs-CRP and BNP was occurred in both groups（P 0.05）.In the 60th day,there were no difference between the two group in conventional index（P 0.05）,but the MMP-2,-9 levels in irbesartan group were much lower than those in enalapril group（P 0.05）;No differences of cardiovascular events incidence were happened in the two groups within six months follow up（P 0.05）.Conclusion Both the irbesartan and enalapril are benefit for the AMI;The effect of irbesartan on AMI is not inferior to enalapril;irbesartan might be used as an alternative medicine for ACEI.

关 键 词：厄贝沙坦 依那普利 心肌梗死 急性 基质金属蛋白酶 

分 类 号：R542.22[医药卫生—心血管疾病]