卡托普利长期治疗心肌梗塞对心脏的保护作用

Cardiac Protection by Long-term Treatment of Captopril in Patients with Acute Myocardial Infarction

101例自出现症状后72h 内入院且无心源性休克的急性心肌梗塞患者,随机分为卡托普利组(52例和常规治疗组(49例。于入院时(1.2±1.1d、出院前(27±10d 和随访期(363±31d 以多普勒超声心动图测定左心室收缩功能和舒张期经二尖瓣血流速度。结果显示,于1年随访期中,卡托普利组患者左心室收缩末期和舒张末期容量减低,射血分数增高。心脏扩大发生率减低。左心室舒张早期充盈速率增高、舒张晚期充盈速率减低,使舒张早期与舒张晚期充盈速率比值增高。然而,常规治疗组患者的平均左心室收缩功能和舒张充盈速率均无显著变化。因此,长期卡托普利治疗对急性心肌梗塞患者心功能具有益的保护作用。

Objectives:To assess the effects of long-term treatment by angiotensin-converting enzyme(ACE)inhibitor with captopril,on cardiac function in acute myocardial infarction(AMI). Methods:One hundred and one patients with AMI who were admitted to hospital within 72 hours of symptoms and had no carciogenic shock were randomly allocated to captopril(n=52;group Ⅰ)and conventional treatment(n=49;group Ⅱ).Left ventricular(LV)systolic performance and diastolic transmitral flow velocity profiles were assessed by Doppler echocardiography at admission (1.2±1.1)days,before discharge(27±10)days and during follow-up(363±31)days.Results:At one year follow-up,in group Ⅰ LV end-diastolic volume decreased,and ejection fraction increased due to a disproportional decrease in end-systolic volume.The occurrence rate of cardiac dilatation was reduced,LV early diastolic filing velocity(E)increased and late atrial filling velocity(A)decreased, resulting in an elevation of E/A ratio.However,the mean values of LV systolic and diastolic functional parameters were unchanged in group Ⅱ.Conclusions:Long-term treatment with captopril exerts a beneficial effect on cardiac protection for patients with AMI.