卡维地洛联合奥美沙坦对左室重构及心力衰竭的影响

Effects of Carvedilol and Olmesartan on left ventricle myocardium remodeling and heart failure

目的观察卡维地洛联合奥美沙坦长期应用治疗心肌梗死患者对左室重构及心力衰竭的疗效。方法选取62例心肌梗死患者,给予卡维地洛和奥美沙坦治疗。于治疗前和治疗后6个月,测定其血浆中肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、血浆醛固酮(ALD)、血浆去甲肾上腺素和肾上腺素的变化;随访2年,分别于治疗前和治疗后测定左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)、左心室舒张期末容积(LVEDV)、左心室收缩期末容积(LVESV)和左心室射血分数(LVEF),观察各组患者在用药前后心室重构的逆转、心脏功能变化。结果治疗组经过2年的治疗后,患者体内PRA、AngⅡ水平均显著下降,治疗前后LVESD下降和LVEF上升,差异均有统计学意义(P<0.05)。结论卡维地洛联合奥美沙坦可以降低体内激素水平,并对左室重构及左室功能均有一定疗效。

Objective To explore the effects of Carvedilol combination with Olmesartan on left ventricular remodeling and heart failure in treatment of patients with myocardial infarction （MI）. Methods All of 62 patients with myocardial infarction were treated with Carvedilol and Olmesartan respectively. The levels of plasma renin activity （PRA）, angiotensin Ⅱ （Ang Ⅱ）, aldosterone （ALD）, plasma norepinephrine and epinephrine were measured before treatment and 6 months after the onset of observation. The left ventricular end-diastolic imension （LVEDD）, left ventricular end-systolic dimension （LVESD）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, left ventricular ejection fraction （LVEF） were measured, and the changes of cardiac remodeling and cardiac function were also observed. Results After treatment for two years, the levels of PRA, Ang Ⅱ in patients were declined obviously and the levels of LVESD and LVEF were statistically different before and after the drugs were used （P 〈 0.05）. Conclusion Application of Carvedilol and Olmesartan can decline the level of hormone and bring some curative effect to left ventricular remodeling and left ventricular function.