硝普钠对急性心肌梗死早期左室重构的影响

目的 观察静脉应用硝普钠对急性心肌梗死患者早期左室重构影响.方法 50例住院ST抬高型的急性心肌梗死患者,全部病例均因经济条件不允许或因door-2-needle时间较晚未能行急诊及择期经皮冠状动脉介入治疗（PCI）或静脉溶栓治疗,患者随机分为治疗组（26例）和对照组（24例）.治疗组在常规治疗基础上予硝普钠泵入,对照组在常规治疗基础上予硝酸甘油泵入＋ACEI/ARB口服.于发病4周后用超声心动图仪测定左室收缩末期容积（LESV）、左室舒张末期容积（LEDA）、左室射血分数（LVEF）及左室舒张早期和晚期充盈速度比值（E/A）.根据患者的体表面积计算左室收缩末期容积指数（LESVI）和左室舒张末期容积指数（LEDAI）,以此评估硝普钠对急性心肌梗死早期左室重构的影响.结果 治疗后,治疗组LESVI、LEDAI、LVEF、E/A与对照组间比较差异有统计学意义（P＜0.05）.结论 静脉应用硝普钠能更有效地防治急性心肌梗死患者早期的左室重构.

Effects of sodium nitroprusside on early left ventricular remodeling after acute myocardial infarction

Objective To study the effects of sodium nitropnisside on early left ventricular remodeling after acute myocardial infarction (AMI). Methods 50 patients with ST segment elevating AMI who hadn' t been PCI or thrombolysis because of the delayed visiting time or poverty were randomly devided into two groups. Treatment group (n = 26) was treated with Sodium Nitropnisside on the basis of routine therapy and control group treated with Nitroglycerol and ACEI/ARB. In 4th week after AMI,left ventricular systolic volume index( LESVI) ,left ventricular diastolic volume index ( LEDAI), left ventricular ejection fraction ( LVEF) and left bventricular diastolic early and advanced stage engorging velocity ratio(E/A) were detected by ultrasonography. Results LESVI and LEDAI were significantly decreased and LVEF and E/A were significant increased after treated with Sodium Nitropnisside. There was significantly difference between two groups. Conclusion Sodium Nitropnisside could effectively prevent and treat patients with early left ventricular remodeling after AMI.