卡托普利对心肌梗死后左室重塑的影响

目的 探讨卡托普利(开搏通)与急性心肌梗死(AMI)后左室重塑的关系.方法 选择首次AMI患者70例,在发病后给予卡托普利治疗,应用彩色多普勒超声显像仪,于发病第4周和52周行超声心动图检查,观察左室形态、大小、室壁运动并记录左室收缩末期内径(LVDs)、舒张末期内径(LVDd)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左房内径(LAD)和二尖瓣血流频谱图中快速充盈E波最大流速(VE)和心房充盈A波最大流速(VA)等指标并计算VE/VA等指标.其中8例退出研究,将不规律应用卡托普利(n=29)和规律服用卡托普利(n=33)患者分为A、B 2组,比较52周时2组超声心动图观察指标.结果 B组的LVDs、LVDd、LVESV、LVEDV和LAD比A组降低,但LVEF和VE/VA比A组升高(P＜0.05).结论 卡托普利可以干预AMI后左室重塑,明显改善左室舒缩功能.

Effect of captopril on the left ventricular remodeling after myocardial infarction

Objective To investigate the influence of captopril on left ventricular (LV) remodeling after acute myocardial infarction (AMI).Methods The 70 patients with first AMI were treated with captopril, and ultrasound cardography examination was performed at 4 and 52 weeks after the attack to detect the changes of LV morphology,heart function contractive moments of LV wall,LVDs,LVDd,LVESV,LVEDV,LVEF,LAD and E/A.These patients were divided into two groups.29 patients in group A were given irregular treatment with captopril;33 patients in group B were given regular treatment with captopirl,8 of 70 patients quitted the study.Results In group B,the LVDs,LVDd,LVESV,LVEDV and LAD significantly decreased and LVEF and E/A increased,as compared with those in group A (P< 0.05). Conclusion Captopril therapy could improve LV performance and reverse LV remodeling in patients with AMI.