西拉普利对急性心肌梗死患者压力反射敏感性的影响

目的评价顿服西拉普利5mg对无合并症急性心肌梗死(AMI)患者压力反射敏感性(BRS)的影响。方法入选23例无合并症的AMI患者为西拉普利组,在其症状发生后2～4天测基础BRS一次,然后口服西拉普利5mg,3h后再测BRS。安慰剂组10例,入选条件相同,口服安慰剂,在同时间测定BRS,从而排除BRS自身的变化。结果服用西拉普利5mg3h后,BRS中位数值从3.769ms/mmHg上升到5.247ms/mmHg(P<0.05),其中54%患者的BRS值上升大于0.5ms/mmHg。对照组服药前后BRS无变化。结论西拉普利可显著改善AMI患者早期的BRS。

The effects of cilazapril on baroreflex sensitivity in patients after acute myocardial infartion

Objective To evaluate the immediate effects of angiotensin-converting enzyme inhibition (cilazapril 5 mg) on baroreflex sensitivy in patients after acute myocardial infartion(AMI). Methods Twenty-three patients after acute coronary syndrome underwent baroreflex sensitivity evaluation 2 to 4 days after symptom onset and 3 hours after taking cilazapril 5 mg. Ten additional patients with the same characteristics were evalueated at the same time intervals before and after placebo administration to identify spontaneous baroreflex sensitivity variations. Baroreflex sensitivity was assesssed by calculating the regression line relating phenylephrine-induced increases in systolic blood pressure to the attendant changes in the RR interval. Results The median baroreflex sensitivity value increased 3 hours after cilazapril administration from 3.769 ms/mmHg to 5.247 ms/mmHg(P<0.05) and individual analyses increased by greater than 0.5 ms/mmHg in 54% of patients. Conclusion Cilazapril can significantly improve the chronotropic response to baroreceptor stimulation.