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目的拮抗神经内分泌激素药物的联合应用对心肌梗死后不同心脏功能患者心室重构及血浆内分泌激素水平的影响。方法2002-02～2003-05解放军总医院对103例心肌梗死的患者根据其射血分数是否正常分为两组:心功能正常组和心功能不全组。心功能正常组:射血分数在正常范围之内(50%～70%);心功能不全组:射血分数低于50%。均给予β受体阻滞剂+血管紧张素转换酶抑制剂联合治疗,比较两组患者在用药前和用药后6个月,心脏功能改善、心室重构逆转及血浆内分泌激素水平变化是否达到统计学意义,并比较两组间在心脏功能改善、心室重构逆转以及血浆内分泌激素水平方面的变化是否有统计学意义。结果用药前后心功能的改善、心室重构的逆转以及血浆内分泌激素水平变化达到统计学意义。两组不同心功能的患者之间在血浆内分泌激素水平变化、心脏功能的改善以及心室重构的逆转方面有统计学的意义。结论联合应用拮抗神经内分泌激素药物能有效降低血浆内分泌激素水平、改善左心室重构及心脏功能,并且对心脏功能不全患者更加明显。
Objective To investigate the effects of combination of neuroendocrine hormones on ventricular remodeling and plasma endocrine hormone levels in patients with different cardiac function after myocardial infarction. Methods 2002-02 ~ 2003-05 People’s Liberation Army General Hospital of 103 cases of myocardial infarction patients according to their ejection fraction is normal divided into two groups: normal cardiac function group and cardiac insufficiency group. Normal heart function group: ejection fraction within the normal range (50% ~ 70%); cardiac dysfunction group: ejection fraction less than 50%. Were given β-blockers and angiotensin-converting enzyme inhibitors combined treatment, two groups of patients before treatment and 6 months after treatment, cardiac function improvement, reversal of ventricular remodeling and changes in plasma levels of endocrine hormone whether statistical The meanings of the two groups were compared between the two groups in terms of improvement of cardiac function, reversal of ventricular remodeling and changes of plasma endocrine hormone levels. Results Before and after treatment, the improvement of cardiac function, reversal of ventricular remodeling and changes of plasma endocrine hormone levels reached statistical significance. There were statistically significant differences in plasma endocrine hormone levels, improvement in cardiac function, and reversal of ventricular remodeling in two groups of patients with different cardiac functions. Conclusion The combination of antagonistic neuroendocrine hormone drugs can effectively reduce plasma endocrine hormone levels, improve left ventricular remodeling and cardiac function, and more obvious in patients with cardiac insufficiency.