卡维地洛对急性心肌梗塞后左心室重塑的疗效

Effects of carvedilol on left ventricular remodeling following acute myocardial infarction

目的:评价卡维地洛对急性心肌梗塞(AMI)患者左心室重塑的疗效。方法:AMI患者41例,入院6h后随机分为卡维地洛组(21例)和常规治疗对照组(对照组,20例)。对照组:仅予常规治疗。卡维地洛组:在常规治疗基础上口服卡维地洛6个月。所有患者在入院后第1、3、14d以及3、6个月行超声心动图检查。测定左心室舒张末容积指数(LVEDVI)、左心室收缩末容积指数(LVESVI)及左心室射血分数(LVEF)的变化,并进行临床观察。结果:(1)对照组在14d及3、6个月时与入院基础值比较,LVEDVI[(61.2±13.1)ml/m2,(60.4±13.6)ml/m2,(61.0±12.6)ml/m2∶(54.2±12.8)ml/m2]及LVESVI[(34.2±8.7)ml/m2,(33.6±7.6)ml/m2,(34.8±8.9)ml/m2∶(28.4±8.6)ml/m2]显著增加(P均<0.05);(2)卡维地洛组与对照组比较14d及3、6个月时LVEDVI[(50.3±9.8)ml/m2∶(61.2±13.1)ml/m2,(49.8±8.7)ml/m2∶(60.4±13.6)ml/m2,(50.1±10.2)ml/m2∶(61.0±12.6)ml/m2]和LVESVI[(25.2±7.5)ml/m2∶(34.2±8.7)ml/m2,(24.6±8.1)ml/m2∶(33.6±7.6)ml/m2,(23.9±7.6)ml/m2∶(34.8±8.9)ml/m2]显著降低(P均<0.05);(3)卡维地洛组与对照组比较14d及3、6个月时,LVEF显著增加[(0.60±0.17)%∶(0.48±0.13)%,(0.56±0.14)%∶(0.49±0.21)%,(0.54±0.12)%∶(0.47±0.17)%,P均<0.05]。结论:卡维地洛能明显减轻急性心肌梗塞后左室重构,且耐受性好。

Objective： To investigate the protective effects of carvedilol on left ventricular remodeling after acute myo- cardial infarction. Methods： A total of 41 patients with AMI were involved in the study. They were randomly divided into carvedilol group （21 cases） and routine therapy control group （control group, 20 patients） 6h after they entered the hospital. The patients in control group only took routine therapy. The patients in carvedilol group took carvedilol for 6 months based routine therapy. At 1st, 3rd, 14th days and 3, 6 months after entering hospital, the left ventricular end systolic volume index （LVESVI）, left ventricular end diastolic volume index （LVEDVI） and left ventricular ejec- tion fraction （LVEF） were measured by eehocardiogram in all patients. Results： （1） At 14th day and 3, 6 months, LVEDVI[（61.2±13.1）ml/m2,（60.4士13.6）ml/m2.（61.0±12.6）ml/m2：（54.2±12.8）ml/m2]及LVESVI[（34.2±8.7）ml/m2,（33.6±7.6）ml/m2,（34.8±8.9）ml/m2：（28.4±8.6）ml/m2,P〈0.05 all] in control group significantly increased when compared with basic index; （2） At 14th day and 3, 6 months, LVEDVI[（50.3±9.8）ml/m2：（61.2±13.1）ml/m2,（49.8±8.7）ml/m2：（60.4±13.6）ml/m2,（50.1±10.2）ml/m2：（6L0±12.6）ml/m2]和LVESVI[（25.2±7.5）ml/m2：（34.2±8.7）ml/m2,（24.6±8.1）ml/m2：（33.6±7.6）ml/m2,（23.9±7.6）ml/m2：（34.8±8.9）ml/m2, P〈0. 05 all] in carvedilol group significantly decreased when compared with those of control group; （3） At 14th day and 3, 6 months, LVEF in earvedilol group significantly increased when compared with those of control group [（0.60±0.17）%：（0.48±0.13）%,（0.56±0.14）%：（0.49±0.21）%,（O.54±0.12）%：（0.47±0.17）%, P〈 0.05 all]. Conclusion.. Carveditol might significantly inhibit left ventricular remodeling following AM1.