缬沙坦与依那普利治疗急性心肌梗死合并心功能不全对照研究

目的探讨缬沙坦与依那普利治疗急性心肌梗死合并心功能不全的临床疗效和安全性。方法将122例急性心肌梗死合并心功能不全患者随机分为观察组与对照组，每组61例，两组均接受溶栓、扩容、调脂、抗凝等常规治疗，在此基础上观察组联合缬沙坦治疗，对照组联合依那普利治疗，观察6个月。于治疗前及治疗6个月末，检测两组收缩压、舒张压、左心射血分数，及时记录治疗过程中出现的不良反应。结果治疗6个月末两组收缩压、舒张压均较治疗前显著下降（P〈0．01），左心射血分数均较治疗前显著升高（P〈0．01），同期两组间比较差异均无显著性（P〉0．05）。治疗后观察组未出现明显的不良反应，对照组不良反应发生率显著高于观察组（χ^2=18．42，P〈0．01）。结论急性心肌梗死合并心功能不全患者在接受溶栓、扩容、调脂、抗凝等常规治疗的基础上，联合缬沙坦与依那普利治疗效果显著且相当，但联合缬沙坦安全性更高。

A control study of valsartan vs. enalapril in acute myocardial infarction combined with cardiac insufficiency

Objective To explore the efficacy and safety of valsartan vs. enalapril in acute myocardial in- farction （AMI） combined with cardiac insufficiency （CI）. Methods A total of 122 AMI patients with CI were randomly assigned to two groups of 61 ones each, both groups received such routine treatment as thrombolysis, expansion, lipid-regulating, anticoagulation and so on, on that basis observation group was plus valsartan and control group plus enalapril for 6 months. At baseline and at the end of the 6th month systolic pressure （SP）, diastolic pressure （DP） and left ventricular ejection fraction （LVEF） were detected, adverse reactions during treatment recorded in time. Results After treatment SP and DP of both groups lowered more significantly （P〈0.01） and LVEF increased （P〈0.01） compared with pretreatment, contemporaneous group comparisons showed no significant differences （P〈0.05）. After treatment there were no apparent adverse reactions in observation group, the incidences of adverse reactions were significantly higher in control than in observation group （χ^2 = 18.42, P〈0.01）. Conclusion Such routine treatments plus valsartan or enalapril have notable and equivalent efficacy as thrombolysis, expansion, lipid-regulating, anticoagulation and so on in the treatment of AMI with CI, but routine treatments plus valsartan has higher safety.