培哚普利对老年人急性心肌梗死后校正QT离散度的影响

Effect of perindopril on changes of corrected QT dispersion in aged patients with acute myocardial infarction

目的 探讨老年人急性心肌梗死 (AMI)后的校正QT离散度 (QTcd)改变及血管紧张素转换酶抑制剂 (A CEI)———培哚普利 (雅施达 )的影响。方法 用随机双盲法将 1996年 1月至 1998年 12月收治的 5 2例老年急性心肌梗死患者分为治疗组 2 6例和安慰剂组 2 6例 ,分别给予培哚普利及安慰剂口服治疗 6周 ,并对治疗前后的QTcd、血管紧张素Ⅱ (AngⅡ )、血醛固酮 (Ald)、左心室射血分数 (LVEF)和室壁运动指数 (WMI)进行检测分析。结果 老年AMI患者的QTcd、AngⅡ、Ald及WMI均明显升高 ,LVEF下降。经培哚普利治疗后 ,QTcd、AngⅡ、Ald及WMI均明显下降 ,LVEF改善。QTcd与AngⅡ、Ald及WMI存在明显的正相关性 (r=0 .418,P <0 .0 1;r=0 .2 15 ,P <0 .0 5 ;r=0 .487,P <0 .0 1) ,QTcd与LVEF存在负相关 (r=- 0 .372 ,P<0 .0 1)。结论 老年AMI患者QTcd明显升高 ;培哚普利能改善QTcd ,可能与肾素 血管紧张素

Objective To investigate the effects of perindopril,an angiotensin converting enzyme inhibitor,on corrected QT dispersion(QTcd)in aged patients with acute myocardial infarction(AMI).Method 52 patients with AMI were double blindly randomized into treatment group,26 patients,and placebo group,26 patients.Oral perindopril or placebo was given respectively for 6 weeks.QTcd, AngⅡ,Ald,LVEF and WMI were measured.A group of 30 normal persons served as controls.Results The results showed that QTcd,AngⅡ,Ald,WMI increased significantly and LVEF was lowered significantly in aged patients with AMI as compared with the normal group.LVEF was increased significantly and QTcd,AngⅡ,Ald and WMI were lowered significantly in perindopril treatment group after 6 weeks of treatment.No consistent change was showed in the placebo group.QTcd showed positive correlation with AngⅡ,Ald and WMI(r=0.418,P<0.01; r=0.215, P<0.05;r=0.487,P<0.01 respectively) and showed negative correlation with LVEF( r=-0.372,P<0.01 ).Conclusion QTcd was increased significantly in aged patients with AMI and perindopril can improve QTcd,which may be related to heart function and renin angiotensin aldosteron system.