氯沙坦和开搏通对急性心肌梗塞后左心室收缩同步性影响的对比研究  

A Comparison Study of Losartan and Captopril on the Left Ventricular Systolic Synchrony Following Acute Myocardial Infarction

作　　者：刘君[1] 傅向华[1] 杨新毅[2] 魏玲格[2] 李亮[1] 马宁[1] 吴伟力[1] 李世强[1] 张斌[1] 

机构地区：[1]河北医科大学第二医院心内科,河北省石家庄市050000 [2]河北医科大学第二医院核医学科,河北省石家庄市050000

出　　处：《中国循环杂志》2001年第1期27-29,共3页Chinese Circulation Journal

摘　　要：目的 :对比血管紧张素 受体拮抗剂和血管紧张素转换酶抑制剂对急性心肌梗塞 (AMI)后左心室收缩同步性(L VSS)的影响。　　方法 :10 0例 AMI患者随机分为常规治疗组 2 0例、开搏通组 40例、氯沙坦组 40例 ,于 AMI后 1周、4周、2 8周进行平衡法核素心室造影和心室相位分析 ,获得相位分布 /直方图和 L VSS参数。　　结果 :AMI后 2 8周时 ,氯沙坦组和开搏通组与其 AMI后 1周比较梗塞区延迟相位均有明显改善 ,直方图曲线负偏态消失。 AMI后 2 8周时开搏通组 L VSS定量参数左心室相角程、左心室半高宽和左心室峰相位标准差分别较 AMI后 1周时降低 2 5 .43%、35 .86 %和 2 1.41% (P均 <0 .0 5 ) ,氯沙坦组左心室相角程、左心室半高宽和左心室峰相位标准差分别降低 33.0 4% (P<0 .0 5 )、5 1.47% (P<0 .0 1)和 2 7.5 8% (P<0 .0 1) ,而常规治疗组 1周、4周、2 8周时各参数无明显变化。AMI后 2 8周时氯沙坦组和开搏通组较常规治疗组左心室相角程、左心室半高宽和左心室峰相位标准差分别减少2 9.90 %和 2 5 .91% (P均 <0 .0 1)、5 0 .77% (P<0 .0 1)和 44 .33% (P<0 .0 5 )、2 3.43%和 2 5 .2 7% (P均 <0 .0 5 )。而且氯沙坦组与开搏通组间相位分布和上述各参数比较并无显著性差异。　　结论 :血管紧张素Objective:To compare the effect on left ventricular systolic synchrony (LVSS) of angiotension II antagonist(AIIA) losartan versus angiotensin converting enzyme inhibitors(ACEI) captopril after acute myocardial infarction(AMI). Methods:A total of 100 patients with AMI were enrolled in our study.Twenty patients were randomized into conventional treatment group,40 into captopril group and the other 40 into losartan group.The phase imaging and phase histogram of ventricle were observed and the parameters of LVSS(PS,PSD and FWHM) were measureed in all patients of the three groups at 1,4 and 28 weeks after AMI using the technique of phase analysis of equilibrium radionuclide angiography. Results:At 28 weeks after AMI,phase distribution imaging and phase histogram of ventricle were significantly improved in losartan and captopril treatment groups.There was no difference in the LVSS parameters of the three groups at 1 and 4 weeks after AMI.Losartan and captopril treatment groups (28 weeks) were characterized by significantly decreased LPS by 29.90% and 25.91%( p <0 01) LFWHM by 50.77%( p <0 01) and 44.33%( p <0 05) LPSD by 23 43% and 25.27% ( p <0.05)compared with the conventional treatment group.There was no difference between the losartan and captopril treatment groups. Conclusions:Losartan significantly improved the left ventricular systolic synchrony.The effect of losartan was similar to that of captopril.

关 键 词：急性心肌梗塞 氯沙坦 开搏通 左心室收缩同步性 

分 类 号：R542.220.5[医药卫生—心血管疾病]