厄贝沙坦与依那普利改善急性心肌梗死及左室重构的比较研究

Comparison of irbesartan and enalapril for treating patients with acute myocardial infarction

目的观察厄贝沙坦与依那普利对急性心肌梗死及左室重构的疗效。方法将99例急性心肌梗死患者随机分为厄贝沙坦组(48例)与依那普利组(51例)。两组在常规治疗基础上分别加用厄贝沙坦与依那普利,并随访至半年。记录两组在急性期与慢性期的常规诊疗指标,如血压、心率、血脂、超声、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)、心功能、基质金属蛋白酶2、9(MMP-2,9)以及不良心血管事件等不良反应。结果急慢性期两组在常规诊疗指标及心功能比较差异均无统计学意义(P>0.05);慢性期厄贝沙坦组MMP-2,9活性较依那普利组更低(P<0.05);半年内两组患者心血管事件发生率比较差异均无统计学意义(P>0.05),但依那普利组干咳发生率较高(P<0.01)。结论厄贝沙坦对急性心肌梗死的疗效优于依那普利且不良反应低,厄贝沙坦可作为ACEI的替代药物。

Objective To investigate the effects of irbesartan and enalapril on patients with acute myocardial infarction（AMI）. Methods 99 patients with AMI were randomly divided into the irbesartan group（n = 48） and the enalapril group（n = 51）. Each group was given traditional treatment and corresponding drug（ irbesartan or enalapril）and followed up for 6 months. Conventional index,such as blood pressure,heart rate,lipid,ultrasound,high sensitive C reactive protein（hs-CRP）,brain natriuretic peptide（BNP）,heart function score,matrix metalloproteinase 2,9（MMP-2,9） and adverse cardiovascular events,side effect were recorded. Results In acute and chronic period,there was no significant difference between the two group in conventional index and heart function score（P ＆gt; 0. 05）;But in chronic period,the MMP-2,9 levels in irbesartan group were much lower than those in enalapril group（P ＆lt; 0. 05）;No difference of cardiovascular events incidence was occurred in the two groups within six months follow up（P ＆gt; 0. 05）. However,a higher dry cough rate occurred in enalapril group（P ＆lt; 0. 01）. Conclusion The effect of irbesartan on AMI is superior to enalapril,irbesartan might be used as an alternative drug for ACEI.