神经内分泌激素拮抗剂对心肌梗死患者运动耐量和血浆激素的影响

Effect of neuroendocrine antagonist on plasma hormone and exercise tolerance in patients with acute myocardial infarction

目的:评价神经内分泌激素拮抗剂对心肌梗死患者运动耐量以及血浆内分泌激素的影响。方法:急性心肌梗死患者39例,随机分组为厄贝沙坦与卡维地洛联合使用组以及血管紧张素转化酶抑制剂(angiotensinconvertingenzymein-hibitors,ACEI)与美托洛尔联合使用组。各组分别在治疗前后6个月测量6min行走试验以及血浆内分泌激素。结果:与治疗前比较,治疗后6个月厄贝沙坦与卡维地洛联合使用组以及ACEI与美托洛尔联合使用组患者血浆肾素和血管紧张素均减少(t=3.21～3.80,P<0.01);可以使6min行走距离增加,与治疗前比较,差异有显著性意义(t=-7.90,5.72,P<0.01)。结论:血管紧张素受体抑制剂与第3代β受体阻滞剂联合使用以及A-CEI与第2代β受体阻滞剂联合使用都可以降低急性心肌梗死患者血浆内分泌激素,改善患者的心功能状态,提高运动耐量。

AIM: To investigate the effect of neuroendocrine antagonist on plasma endocrin e hormone and exercise tolerance in patients with acute myocardial infarction. METHODS: Thirty-nine patients with acute myocardial infarction were randomly divided into two groups: group A (treated by the combination of irbesartan and c arvedilol) and group B [(treated by the combination of angiotensin converting en zyme inhibitors(ACEI) and β-blockade].Plasma endocrine hormone and 6 minutes' walk test were measured in each group respectively before and 6 months after tre atment. RESULTS:Compared with the situation before treatment, both plasma renin activi ty and angiotensin in patients in group A and group B were decreased (t=3.21-3. 80,P< 0.01) and the distance of 6 minutes' walk was increased six months after t reatment, significantly different from those before treatment (t=-7.90,5.72, P< 0.01). CONCLUSION: Both the combination of ACEI and β-blockade Ⅲand that of ACEI a nd β-blockadeⅡmay decrease the plasma hormone , prevent the chronic heart fai lure and improve the exercise tolerance of patients with acute myocardial infarc tion.