螺内酯联合美托洛尔对改善急性心肌梗死后左心室重构的作用

Improvement of myocardiac-infarction-induced remodeling of ventricles by spironolactone combined with metoprolol

目的:探讨螺内酯联合美托洛尔对改善急性心肌梗死(AMI)后左心室重构的作用。方法:100例AMI患者随机分成治疗组50例(螺内酯联合美托洛尔治疗)和对照组50例(单纯应用螺内酯治疗),采用彩色多普勒心动超声仪分别于发病后初期(<24 h)和0.5年后观察左心室形态和构型等各项指标,比较两组发生左心室重构状况。结果:治疗组在0.5年后超声指标LVESD、LVEDD、LVPWT、LVEF、ASL和RAPD较入院时均有显著改善(P<0.05),其中LVESD、LVEDD、LVEF、RAPD和ASL比对照组改善明显(P<0.05);对照组仅LVESD、RAPD、LVEF改善明显(P<0.05)。结论:AMI后应用螺内酯联合美托洛尔对晚期并发左心室重构的抑制作用明显,值得临床中广泛应用。

Objective ：To study the effect of spironolactone combined with metoprolol on improving left ventricular remodeling （LVR） in acute myocardial infarction（ AMI }. Methods：Half of a hundred patients with AMI were randomly divided into the treat- ment group （ spironolactone combined metoprolol ） , and the other 50 patients were treated as the control （ spironolactone alone }. Left ventricular shape, configuration and other indicators were measured by color Doppler ultrasound to assess ventricular remode- ling at 24 h and six months after administration of the drugs. Results：Compared with the control group, LVESD. LVEDD, LVEF, RAPD and ASL in the treatment group were significantly improved at six months （ P 〈 0.05 }. In the treatment group, LVESD, LVEDD, LVPWT, LVEF, ASL and RAPD were significantly improved at six months than prior to the admission （ P 〈 0.05 ） while in the control group, only LVESD, RAPD and LVEF were significantly improved at six months （ P 〈 0.05 ）. Conclusions ： Spirono- lactone combined with metoprolol can effectively improve the remodeling of the left ventricle induced by AMI.