MRI评价螺内酯对急性心肌梗死患者心室重构的影响

Study of MRI in Evaluating the Effect of Spironolactone on Left Ventricular Remodeling Patients with Acute Myocardial Infarction

目的探讨应用小剂量螺内酯干预急性心肌梗死(AMI)患者左室重构(LVRM)的影响。方法80例AMI患者,采用随机、对照方法,分为对照组(n=38)常规治疗,螺内酯组(n=42)在常规治疗的基础上加用螺内酯40mg/d。在治疗6个月内检测2组患者血清Ⅲ型前胶原氨基端肽(PⅢNP)、血清透明质酸(HA)及心脏核磁共振,以评价左室纤维化和左室功能。结果治疗6个月后,螺内酯组PⅢNP、HA较对照组明显下降(P<0.01),左室收缩末期内径与对照组相比明显下降,LVEF明显升高,延迟强化灶体积明显下降(P<0.05)。结论常规治疗的基础上联合应用小剂量螺内酯,可进一步抑制左室重构、改善心功能。

Objective To investigate the effect of spironolactone on left ventricular remodeling（LVRM） in patients with acute myocardial infarction.Methods In this randomized,controlled study, 80 AMI patients were divided into routine treatment group（n=38） and spironolactone intervention group（n=42）.Spironolactone 40mg/d was administered in addition to the routine treatment for patients of spironolactone intervention group.During the 6 months,the serum PⅢ NP,HA and MRI were examined in all patients to assess myocardial fibrosis and LV function.Results After 6-month intervention,P Ⅲ NP and HA serum levels were significantly lower in the spironolactone intervention group（P〈0.01）;the spironolactone intervention group had a lower LVESD and delayed enhancement volume, had a higher LVEF compared with controlled group（P〈0.05）. Conclusion In patients with AMI,spironolactone combined with the routine treatment could inhibit LVRM and and improve LV function.