培哚普利对置入永久性起搏器后心肌重构的影响

Effect of perindopril on myocardial remodeling after permanent pacemaker implantation

目的评价培哚普利对置入永久性心脏起搏器后心肌重构的影响。方法连续入选置入永久性起搏器患者112例,随机分为治疗组及对照组,每组56例。治疗组给予口服培哚普利,2～8 mg/d;对照组不给予血管紧张素转换酶抑制剂类药物。采用二维超声心动图检测患者置入永久性心脏起搏器前后心脏各参数,随访18个月。结果与置入前比较,对照组左心室重量指数增加(P<0.05),治疗组LVEF明显增加(P<0.05)。18个月时,2组左心室重量指数比较差异有统计学意义(P<0.05),治疗组LVEF显著高于对照组(P<0.05)。结论永久性起搏器置入18个月时,患者心肌重构已出现改变。培哚普利可改善患者心肌重构,但仍需要长期的随访。

Objective To investigate the influence of perindopril on left ventricular remodeling after implantation of permanent pacemaker. Methods 112 cases who received implantation of permanent pacemaker were selected. They were divided into two groups randomly：one group of patients were treated with perindopril 2--8 mg once daily for less than one month after implantation of permanent pacemaker and the other group served as control group. After 18 months,the LVEDD, LA,RV,RA, IVS, LVPW, LVMI were examined and analyzed by echocardiography of GE V7- type. Results At baseline before management, the two groups had no significant difference in clinical features and heart morphological images. Eighteen months later, the control group showed increase in LVMI （P〈 0. 05）. LVEF level was higher in treatment group than in control group （P 〈 0.05）. Conclusion Early stage of myocardial remodeling has already been observed 18 months after implanting permanent pacemakers. Perindopril can improve myocardial remodeling,but long-term observation is still needed.