不同血管紧张素转化酶抑制剂对急性心肌梗死患者冠状动脉介入术后肾功能影响的研究  

Effect of different ACEI drugs on renal function in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：周音频[1] 胡鑫渝 肖鹏[1] 宁琳[1] 向立权[1] Zhou Yinpin;Hu Xinyu;Xiao Peng(Department of Cardiology,Fuling Central Hospital in Chongqing,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院心内科

出　　处：《中华保健医学杂志》2020年第1期26-29,共4页Chinese Journal of Health Care and Medicine

基　　金：重庆市卫生局重点课题(2013-1-050)

摘　　要：目的对比分析不同血管紧张素转化酶抑制剂(ACEI)用于急性心肌梗死患者冠状动脉介入术后对患者肾功能的影响。方法前瞻性选取重庆市涪陵中心医院2015年11月~2018年12月收治的急性心肌梗死患者150例,根据随机数表法分为两组,各75例。全部患者均接受冠状动脉介入术治疗,术后75例接受培哚普利治疗者作为培哚普利组,75例接受福辛普利钠治疗者作为福辛普利钠组,全部患者均持续用药6个月。分别于治疗前、治疗6个月后检测并比较两组左室舒缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)等心功能指标;血清肌酐(SCr)、血尿素氮(BUN)等肾功能指标;记录并比较两组肾功能异常发生情况。结果治疗6个月后,两组患者LVESD、LVEDD水平均较治疗前降低,LVEF较治疗前升高,差异有统计学意义(P <0.05),但组间各指标差异均无统计学意义(P> 0.05);两组患者血清SCr、BUN水平均较治疗前升高,但福辛普利钠组各指标水平低于培哚普利组,差异有统计学意义(t=2.413、2.900,P <0.05)。两组不良反应发生率比较,差异无统计学意义(P> 0.05);福辛普利钠组肾功能异常发生率低于培哚普利组,差异有统计学意义(P <0.05)。结论福辛普利钠与培哚普利用于急性心肌梗死患者冠状动脉介入术后,均能改善患者心功能,但福辛普利钠的应用较培哚普利带来的肾功能方面的影响更小,肾功能异常发生率更低,安全性更好,可作为急性心肌梗死患者冠状动脉术后首选ACEI用药。Objective To compare and analyze the different angiotensin converting enzyme inhibitors(ACEI)on renal function in patients with acute myocardial infarction after percutaneous coronary intervention(PCI). Methods The prospective study was adopted.150 patients with acute myocardial infarction who admitted in the hospital from November 2015 to December 2018. All patients underwent PCI,and after surgery,75 patients who were in perindopril group,And 75 patients who were in fosinopril group.Before treatment and 6 months after treatment,the cardiac function parameters [left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],renal function parameters [serum creatinine(SCr),blood urea nitrogen(BUN)]at different time were detected and compared between two groups.The incidence of renal dysfunction in two groups during treatment was recorded and compared. Results After treatment for 6 months,the LVESD and LVEDD in two groups were lower than those before treatment(P < 0.05),and the LVEF was higher than that before treatment(P <0.05),but the difference between the two groups after treatment was not statistically significantly(t=1.932,1.928,0.375,P > 0.05);After treatment for 6 months,the levels of SCr and BUN in two groups were higher than those before treatment,and the levels of parameters in fosinopril sodium group were lower than those in perindopril goup,and the difference was statistically significant(t=2.413,2.900,P < 0.05).The chi-square test confirmed that there was no statistical difference in the incidence of adverse reactions between two groups(P > 0.05)But the incidence of renal dysfunction in fosinopril sodium group was lower than that in perindopril group,and the difference was statistically significant(P < 0.05). Conclusion Fosinopril sodium and perindopril in patients with acute myocardial infarction after PCI can improve cardiac function.However,the application of fosinopril sodium has less effect on renal function than perindopril,i

关 键 词：急性心肌梗死 冠脉介入术 福辛普利钠 培哚普利 心功能 肾功能 

分 类 号：R542.22[医药卫生—心血管疾病]