卡托普利联合美托洛尔对急性心肌梗死晚期左心室重构的影响

目的探讨急性心肌梗死(AMI)后应用卡托普利联合美托洛尔治疗与单用卡托普利治疗对晚期左心室重构的影响。方法将121例AMI患者随机分成治疗组(卡托普利联合美托洛尔)63例和对照组(卡托普利)58例,采用彩色多普勒心动超声仪分别于发病后早期(<24 h)、3、6个月末连续随访并测量、计算左心室形态、构型等多项指标。结果进行治疗组早期到6个月末前后比较,左心室形态均呈逐渐扩大,6个月末最大,对照组扩大程度更明显。对照组与治疗组同期对应比较,左心室形态逐渐扩大,6个月末最明显,且差异有显著性意义。同时左心室射血分数同组和两组间对应比较,均有明显改善(P<0.05,P<0.01)。结论AMI后应用卡托普利联合美托洛尔对晚期左心室重构的抑制作用明显优于单用卡托普利。

Effect of captopril combined with metoprolol on left ventricular remodeling after acute myocardial infarction

Objective To study the effects of captopril in combination with metoprolol and single captopril on left ventricular remodeling(LVR) after acute myocardial infarction(AMI).Methods The indexes such as left ventricular shape and geometry were measured in 121 patients with AMI including 63 in treatment group(captopril and metoprolol) and 58 in control group(captopril) at early phase(<24hours),3 and 6 months after the attack using echocardiography.Results The changes of left ventricular shape and geometry in control group were more obvious than those in treatment group from early phase to 6 months(P<0.05,P<0.01).Conclusion The captopril in combination with metoprolol was more effective in inhibition of LVR than single captopril in late stage of AMI.