咪达普利对非高血压AMI患者溶栓后血浆CRP、BNP水平及心功能的影响

目的观察血管紧张素转换酶抑制剂(ACEI)咪达普利对非高血压急性心肌梗死(AMI)患者溶栓后血浆C反应蛋白(CRP)、脑钠肽(BNP)水平及心室重构、心功能的影响。方法 选取血压正常并溶栓成功的AMI患者65例,随机分为ACEI治疗组(观察组)33例和常规治疗组(对照组)32例。对照组给予常规治疗,观察组在常规治疗基础上给予咪达普利5mg/d。于溶栓前及溶栓后24 h、100 d测量患者血浆CRP、BNP水平,并行超声心动图测定患者舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)、左室射血分数(LVEF)。结果 与溶栓前比较,溶栓24h、100 d后观察组、对照组的CRP、BNP水平均降低(P<0.05),且观察组100 d时降低程度大于对照组,差异有统计学意义(P<0.05)。与溶栓24 h比,溶栓100 d观察组明显改善且较对照组同时期改善明显(P<0.05)。2组EDVI、ESVI及LVEF数值比较差异均有统计学意义(P<0.05)。结论 急性心肌梗死患者应用咪达普利能够明显降低血浆CRP及BNP水平,延缓心肌重构、改善心肌缺血及心功能。

Effects of imidapril on the levels of CRP,BNP,ventricular remodeling and heart function in acute myocardial infarction patients without hypertension after thrombolysis

Objective To investigate the effects of ACEI（imidapril） on the levels of the CRP and,ventricular remodeling and heart function in acute myocardial infarction（AMI） patients without hypertension after thrombolysis.Methods Select 65 normotensive patients with AMI and successful thrombolysis,these cases were randomly divided into ACEI treatment group（observation group） with 33 cases,and the conventional treatment group（control group） with 32 cases.The control group received conventional treatment,observation group were given imidapril 5mg/d with the conventional therapy.Before thrombolysis and after thrombolysis 24 h,100 d,measured plasma CRP,BNP levels in these patients,measured by echocardiography with concurrent end-diastolic volume index（EDVI）,end-systolic volume index（ESVI）,left ventricular ejection fraction（LVEF）.Results Compared with those before treatment,24h and 100 d after treatment,CRP and BNP levels were lower in the observation group and the control group（P〈0.05）,while the observation groups reduce degree obviously than the control group at 100 d,the difference was statistically significant（P〈0.05）.compared with after thrombolysis 24 h,after thrombolytic 100 d,the observation group improvement better than the control group,the differences was significantly（P0.05）.There were statistically significant differences of EDVI,ESVI and LVEF values between the 2 groups（P0.05）.Conclusion Taking ACEI early in acute myocardial infarction patients could decrease the CRP,BNP levels obviously,and inhibit or reverse ventricular remodeling,improve myocardial ischemia and heart function.