伊贝沙坦对急性心肌梗死后左室功能及重塑的影响

Effects of irbesartan on remodeling of the left ventricular following acute myocardial infarction

目的 :观察伊贝沙坦对急性心肌梗死 (AMI)后左室重塑的阻抑作用。方法 :将 72例 AMI患者随机分为常规治疗组 36例、伊贝沙坦治疗组 36例 ,并于 AMI后 2、2 4周分别进行超声心动图和平衡法核素心室造影 ,测定左室心肌质量、左室收缩功能和舒张功能 ,了解伊贝沙坦对 AMI后左室重塑的阻抑作用。结果 :AMI后 2 4周时伊贝沙坦与常规治疗组比较室间隔厚度、左室后壁厚度、左室舒张末内径和左室心肌质量指数均明显降低 (P<0 .0 5或 P<0 .0 1)。AMI后 2 4周时 ,伊贝沙坦治疗组与对照组比较左室射血分数明显增加 (P<0 .0 5 ) ,左室高峰射血率明显升高 ,左室高峰射率时间显著下降 (P均 <0 .0 5 ) ,同时左室高峰充盈率明显升高(P<0 .0 1) ,左室高峰充盈率时间显著下降 (P<0 .0 1)。结论 :伊贝沙坦能明显减轻心肌梗死后心肌肥厚和左室重塑 ,改善左室功能。

Objective: To compare the inhibitory effects of irbesartan on left ventricular remodeling(LVRM) after acute myocardial infarction(AMI) Methods: A total of 72 patients with AMI were entered into the study, 36 patients were randomized to conventional treatment group, and 36 patients to irbesartan treatment group. At 2nd week and 24th week after AMI, the left ventricular myocardium weight was measured by echocardiogram, and the parameters of left ventricular systolic and diastolic function were measured by equilibrium radionuclide angiography Results: At 24th week, interventricular septal thickness (IVST) , left ventricular posterior wall thick(LVPWT), left ventricular diastolic diameter(LVDd) and left ventricular mass index(LVMI) in irbesartan treatment group were significantly decreased( P <0 05 or P <0 01) compared with conventional treatment group At 24th week, left ventricular ejection fraction(LVEF), left ventricular peak ejecting rate(LPER) and left ventricular peak filling rate(LPFR) in irbesartan treatment group were significantly increased( P <0 05 or P <0 01) compared with those in conventional treatment group, respectively. Left ventricular time of peak ejecting rate(LTPER) and left ventricular time of peak filling rate(LTPFR) in irbesartan group were decreased( P <0 05 or P <0 01) compared with the conventional treatment group, respectively Conclusion: Irbesartan might significantly reduce myocardial hypertrophy and LVRM after AMI. Irbesartan improves the left ventricular systolic function