螺内酯联合贝那普利治疗急性前壁心肌梗死患者的临床疗效

Therapeutic effect of spironolactone combined benazepril on patients with acute anterior myocardial infarction

目的:探讨螺内酯联合贝那普利治疗急性前壁心肌梗死患者的临床疗效及对左心室重构的影响。方法:选择本院收治的100例急性前壁心肌梗死患者为研究对象,按照不同治疗方案分为贝那普利组(50例)和联合治疗组(50例,螺内酯和贝那普利联合治疗),治疗6个月,对两组疗效、左心室重构及不良反应情况进行对比。结果:与治疗前比较,治疗6个月后,两组心率变异性(HRV)各指标和左室射血分数(LVEF)均明显提高,左室收缩末期内径(LVESd)和左室舒张末期内径(LVEDd)均明显缩小(P<0.05或<0.01);且与贝那普利组比较,治疗后联合治疗组HRV各指标,LVEF[(52.45±8.65)%比(57.85±9.70)%]明显提高,LVESd[(36.25±2.13)mm比(30.10±2.06)mm]和LVEDd[(58.60±6.41)mm比(51.29±6.20)mm]明显缩小(P均<0.01);两组治疗后总不良反应率无明显差异(P=1.000)。结论:联合螺内酯和贝那普利治疗急性前壁心肌梗死患者能明显改善患者心率变异性心功能,抑制左心室重构,且不良反应少。

Abstract ： Objective： To explore therapeutic effect of spironolactone combined benazepril on patients with acute ante- rior myocardial infarction （AAMI） and its influence on left ventricular remodeling. Methods： A total of 100 AAMI patients treated in our hospital were regard as study object. According to therapeutic method, they were divided into benazepril group （n = 50） and combined treatment group （n = 50, received spironolactone combined benazepril）, both groups were treated for six months. Therapeutic effect, left ventricular remodeling condition and incidence of adverse reactions were compared between two groups. Results： Compared with before treatment, after six-month treatment, there were significant rise in all indexes of heart rate variability （HRV） and left ventricular ejection fraction （LVEF）, and significant reductions in left ventricular end-systolic dimension （LVESd） and left ventricular end-diastolic dimension （LVEDd） in two groups, P d0.05 or d0.01; compared with benazepril group after treatment, there were significant rise in all HRV indexes and LVEF [ （52.45 ± 8. 65） % vs. （57. 85 ± 9.70） %], and significant reductions in LVESd [- （36. 25 ± 2.13） mm vs. （30. 10 ± 2.06） mm] and LVEDd E （58.60 ± 6. 41） mm vs. （51.29 ± 6. 20） mini in combined treatment group, P%0.01 all; there was no significant difference in total adverse reaction rate between two groups, P = 1. 000. Conclusion： Spironolactone combined benazepril can significantly improve HRV and heart function, inhibit left ventricular remodeling in patients with acute anterior myocardial infarction.