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目的:研究缬沙坦及合用安体舒通对经再灌注治疗的急性心肌梗死患者血清胶原水平和心功能的影响。方法:首次急性前壁心肌梗死伴室壁瘤患者70例,随机分为缬沙坦组、合用药组(缬沙坦合用安体舒通),在治疗后1周、2周、12周测定血清Ⅰ型前胶原羧基末端肽(PⅠCP)和Ⅲ型前胶原氨基末端肽(PⅢNP)浓度;并在治疗后2周、12周进行二维超声心动图检查。结果:12周时合用药组血清PⅢNP、血清PⅠCP较缬沙坦组明显降低(P<0.05)。合用药组的舒张末期容积指数、收缩末期容积指数、局部室壁运动指数、左室射血分数及左室质量指数较缬沙坦组明显改善(P<0.05)。结论:缬沙坦能够阻抑急性心肌梗死伴室壁瘤患者的胶原合成,改善心室收缩和舒张功能;合用药组的作用优于单用缬沙坦,显著改善心室收缩和舒张功能。
Objective: To investigate the effects of valsartan and spironolactone on serum collagen and cardiac function in patients with acute myocardial infarction after reperfusion. Methods: Seventy patients with acute anterior myocardial infarction with aneurysm were randomly divided into valsartan group and combination group (valsartan combined with spironolactone), and were measured at 1 week, 2 weeks and 12 weeks after treatment Serum procollagen carboxyterminal peptide (PⅠCP) and type Ⅲ procollagen aminopeptidase (PⅢNP) were measured. Two-dimensional echocardiography was performed at 2 weeks and 12 weeks after treatment. Results: Compared with valsartan group, PⅢNP and PⅠCP in the combination group were significantly decreased at 12 weeks (P <0.05). Compared with valsartan group, the end-diastolic volume index, end-systolic volume index, regional wall motion index, left ventricular ejection fraction and left ventricular mass index of the combination group were significantly improved (P <0.05). Conclusion: Valsartan can inhibit collagen synthesis in patients with acute myocardial infarction with aneurysm and improve ventricular systolic and diastolic function. The effect of combination group is better than that of valsartan alone and significantly improve ventricular systolic and diastolic function.