依普利酮对急性心肌梗死患者心室重构的影响

摘要

Objective To investigate the effect of eplerenone on ventricular remodeling in patients with acute myocardial infarction.Methods Totally 120 patients with acute myocardial infarction from January 2008 to October 2012 were enrolled and randomly divided into control group (60 cases) undergoing standard treatment program and observation group (60 cases) administrated with oral eplerenone (40-60 mg/d,at twice or three times) in addition to the standard treatment program.The total efficiency was evaluated.The left ventricular end-diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),systolic mitral annular displacement,longitudinal fractional shortening and symptom score before and after treatment were assessed and compared between two groups.Results The efficiency of observation group was significantly higher than that of control group [91.7％ (55/60) vs 80.0％ (48/60)] (x2 =7.222,P ＜ 0.05).After treatment,the symptom score,LVEDD,LVESD in treatment group were significantly lower,the systolic mitral annular displacement and longitudinal fractional shortening were significantly higher than those in control group [(12 ±4) scores vs (16 ±4) scores,(51 ±7) mm vs (58±7) mm,(37±5)mmvs (46±5) mm,(13.3±0.5) mm vs (11.0±0.4) mm,(17.4±1.6)％ vs (13.7 ±1.5)％] (all P＜0.05).Conclusion Eplerenone can effectively reduce the infarction ventricular remodeling and improve the ventricular function in patients of acute myocardial.%目的 探讨依普利酮对急性心肌梗死患者心室重构的影响.方法 选取2008年1月至2012年10月在湖北医药学院附属东风医院介入治疗中心就诊的120例首发急性心肌梗死患者,完全随机分为观察组与对照组,各60例.对照组常规治疗,观察组在对照组基础上加用依普利酮治疗,40～60 mg/d,分2次或3次口服.比较2组患者治疗有效率、治疗前后症状评分、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、二尖瓣环的收缩期最大位移和左心室长轴缩短率.结果 观察组有效率明显高于对照组[91.7％ (55/60)比80.0％ (48/60)],差异有统计学意义(2=7.222,P＜0.05).治疗后,观察组症状评分、LVEDD、LVESD均明显低于对照组[(12±4)分比(16±4)分、(51 ±7)mm比(58 ±7)mm、(37 ±5)mm比(46 ±5)mm],差异均有统计学意义(均P＜0.05).治疗后观察组二尖瓣环的收缩期最大位移与左心室长轴缩短率均高于对照组[(13.3 ±0.5)mm比(ll.0±0.4)mm、(17.4±1.6)％比(13.7±1.5)％],差异有统计学意义(P＜0.05).结论 依普利酮应用于急性心肌梗死患者,可减轻心室重构,改善心室功能,促进预后健康.