替米沙坦与培哚普利治疗急性心肌梗死疗效比较

目的比较替米沙坦与培哚普利治疗急性心肌梗死的疗效。方法将67例急性心肌梗死患者随机分为替米沙坦组37例与培哚普利组30例。所有患者给予基础治疗,并分别加用替米沙坦与培哚普利,随访半年。比较2组急、慢性期临床诊疗指标包括血压、心率、超声、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)、基质金属蛋白酶(MMP)-2、MMP-9及心功能,并随访半年内的心血管事件及不良反应。结果急慢性期2组一般临床诊疗指标比较无显著性差异(P0.05),但替米沙坦可更显著降低血清MMP-2、MMP-9浓度(P均0.05);半年内2组患者心血管事件发生率无显著性差异(P0.05),但培哚普利组干咳发生率更高(P0.01)。结论替米沙坦对急性心肌梗死的疗效不劣于培哚普利且不导致干咳,可作为ACEI的替代药物。

Comparison of the curative effect of telmisartan and perindopril on acute myocardial infarction

Objective It is to compare the effects of telmisartan and perindopril on acute myocardial infarction （AMI）.Methods 67 patients with AMI were randomly divided into telmisartan group （n =37） and perindopril group（n =30）.Each group was given traditional treatment and corresponding drug （telmisartan or perindopriI） and followed up for 6 months.The clinical diagnosis and treatment indexes （blood pressure,heart rate,ultrasound,high sensitive C reactive protein （hs-CRP）,brain natriuretic peptide （BNP）,matrix metalloproteinase 2,9 （MMP-2,9） and heart function were recorded and compared in both groups.The adverse cardiovascular events and side effects were followed up for six months.Results In acute and chronic period,there was no difference in conventional indexes between the two groups （P ＞ 0.05） ; but telmisartan could lower down the serum MMP-2,9 levels more significantly （P ＜ 0.05） ; no difference of cardiovascular events incidence was occurred in the two groups within six months following up（P ＞ 0.05）.However,a higher dry cough rate was occurred in perindopril group （P ＜ 0.05）.Conclusion The effect of telmisartan on AMI is not inferior to perindopril and it does not cause a dry cough ; telmisartan might be used as an alternative drug for ACEI.