氯沙坦和倍他乐克对急性心肌梗死患者左心室重塑的影响

目的 :对比血管紧张素Ⅱ受体拮抗剂 (ARB)氯沙坦和选择性 β1 受体阻滞剂倍他乐克对急性心肌梗死(AMI)后左心室重塑的影响 ,并初步探讨其作用机制。 方法 :82例急性心肌梗死患者随机分为氯沙坦组和倍他乐克组 ,入院时行超声心动图测定左心室内径 (LVDd)、室间隔厚度 (IVSd)、左心室后壁厚度 (LVPW ) ,并计算左心室重量 (LVM) ,治疗 6周后复查上述指标。 结果 :治疗 6周后 ,氯沙坦组与倍他乐克组LVPW、IVSd、LVM与AMI 1周时比较均有改善 (P <0 .0 5 ) ;氯沙坦组较倍他乐克组各指标改善明显 (P <0 .0 5 )。 结论 :氯沙坦、倍他乐克均有减轻心肌梗死后左心室重塑的作用 ,但氯沙坦优于倍他乐克。

Effect of losartan, metoprolol on left ventricular rmodeling in acute myocardial infarction

Objective: This study was to compare effects of losartan, metoprolol on postinfarcted ventricular remodeling. Methods: 73 patients with acute myocardial infarction were randomly divided into 2 groups: losartan group, metoprolol group. The parameters of LVDd, IVSd, LVPW were examined by echocardiography, and LVMI was measured before, and after the therapy. Results: In two group, left ventricular septum thickness and posterior wall thickness show the trend of decrease and have statistically significant (P<0.05), left ventricular mass index was reduce significant (P<0.05) before and after therapy. In losartan group, these parameters were significantly different with that in metoprolol group after treatment. Conclusion: Losartan and metoprolol can improve left ventricular remodeling in acute myocardial infarction, the effect of losartan was better than metoprolol.