氯沙坦和螺内酯对急性前壁心梗左心室纤维化抑制作用研究

Study on Inhibition of Spironolactone and Losartan on Left Ventriclar Fibrosis of Acute Antetheca Myoctardial

目的：观察急性前壁心梗患者分别使用螺内酯和氯沙坦治疗后血浆Ⅲ型前胶原（PIIINP）、层黏连蛋白（LN）和透明质酸（HA）浓度变化。探索醛固酮受体拮抗剂和血管紧张素受体阻断剂对AMI后心室重构和胶原增生的影响。方法：132例AMI患者均为2007年5月至2008年11月于我院住院患者。其中男性82例，女50例，年龄41～65岁之间。按入院时间分为3组：氯沙坦组48例，螺内酯组48例和对照组48例。入院后（9±1）天及发病后3月、6月和12月分别测定血浆PⅢNP、LN和HA的浓度。结果：入院后（9±1）天氯沙坦组与螺内酯组患者血浆PⅢNP、LN和HA浓度无明显差异，与对照组比较明显增高，但3月、6月和12月后比较其浓度进行性降低，且对照组高于治疗组。结论：氯沙坦和螺内酯可抑制急性前壁心梗左室纤维化。

Objective： To investigate the effect of spironolactone and losartan on plasma Ⅲ precollage, laminin and hyaluronic acid in acute antetheca myoctardial patients to explore the effect of aldosterone receptors antagonist and angiotensin receptors blocking pharmacon on myocardium collagen in post-myocardial infarction patients. Methods： 132 AMI patients were patients admitted in our hospital during 2007 July to 2008 November. During which were 82 males and 50 femals, age range from 41 to 65 years old, these patients were divided into 3 groups according to admitted time： losartan group, spironolactone group and control group, each were 48 cases. Plasma PⅢNP, LN and HA was detected in （9±1） day and 3 months and 6 months after the infarction. Results： Compared with the control group, the level of PⅢNP, LN and HA in （9±1） day is much higher., there is no significant differerce between losartan group and spironolactone group. But their levels has progressively decreased in 3, 6 and 12 months compared with the control group, and higher than that of control group. Conclusion： Losartan and spirohctone can effectively decrease left ventriclar fibrosis of acute antetheca myoctardial.