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本文认为应用血管紧张素转换酶抑制剂能影响急性心肌梗死后的左室重构,如:在其演进期应用,可抑制循环和局部组织的血管紧张素Ⅱ的形成,使血管扩张,减轻左室负荷,减少心肌需氧量,从而限制梗塞范围,减轻左室重构;在再灌注前应用,有利于清除氧自由基,而减轻再灌注损伤;在梗塞后应用,可通过减轻心室前后负荷,来防止非梗塞节段的拉长、心腔扩大和心室球形化,改善左室功能。文内提出了对前壁梗塞伴有左心功能不全或恶性心律失常者适宜早期应用卡托普利治疗。但对下壁梗塞者应慎用,对伴低血压和心动过缓者禁用等。对该药的应用剂量及应用时间亦进行了讨论。
This article suggests that the application of angiotensin-converting enzyme inhibitors can affect left ventricular remodeling after acute myocardial infarction, such as: its application in the evolvement phase can inhibit the formation of circulating and local tissue of angiotensin Ⅱ, vasodilation and reduce left Room load, reduce myocardial oxygen demand, thereby limiting the infarct size, reduce left ventricular remodeling; before reperfusion, is conducive to scavenging oxygen free radicals, while reducing reperfusion injury; after the application of infarction, by reducing ventricular anterior and posterior load , To prevent the elongation of non-infarct segments, heart chamber expansion and ventricular spheroidization, improve left ventricular function. The article proposed the appropriate use of captopril for the treatment of anterior infarction with left ventricular dysfunction or malignant arrhythmia. However, the wall infarction should be used with caution, with low blood pressure and bradycardia disabled and so on. The dose of the drug and the application time are also discussed.