我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

急性ST段抬高性心肌梗死后立即使用螺内酯对左室重构的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第4期
页码:
444-446
栏目:
临床研究
出版日期:
2008-08-20

文章信息/Info

Title:
Effect of immediate administration of spironolactone on left ventricular remodelong after acute myocardial infarction
作者:
赵永志; 李爱兰; 吴明永; 王勇; 张道华
菏泽市立医院心内科，山东 菏泽 274031
Author(s):
ZHAO Yongzhi;  LI Ailan;  WU Mingyong;  WANG Yong;  ZHANG Daohua
Department of Cardiology, Municipal Hospital of Heze City, Heze 274031, Shangdong, China
关键词:
心肌梗死; 急性; 醛固酮拮抗剂; 螺内酯; 左室重构
Keywords:
myocardial infarction acute;  spironolactone;  left ventricular remodeling
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 评价醛固酮拮抗剂螺内酯对急性ST段抬高型心肌梗死（STEMI）后左室重构和心功能的影响。方法 连续入选160例STEMI患者，随机分为两组。在发病24 h内，以目前最佳常规药物治疗做对照组（79例），在常规治疗基础上加用螺内酯做螺内酯组（81例）。两组患者均在STEMI后24 h内做多功能超声心动图检查，测定并计算左室收缩末期容积指数（LVESVI）、左室舒张末期容积指数（LVEDVI）、室壁运动积分指数（WMSI），左室射血分数（LVEF），1月后由专人复查。结果 两组基线临床特征及各项超声心动学指标无显著差异，治疗1月后，两组各项超声心动学指标均有明显改善（P<005），但螺内酯组各项指标的改善又显著优于对照组（P<005）。结论 在STEMI发病后常规治疗基础上立即加用螺内酯可进一步加强抗左室重构的作用，进一步改善心脏功能。
Abstract:
AIM To Evaluate the effect of Mineralocortcoit receptor antagonist (MRA) Spironolactone on postinfarct left ventricular remodeling (LVRD). METHODS One hundred and sixty patients with first anterior AMI were randomly divided into MRA group (n=81) and nonMRA group (n=79). All the patients were given agiotensinconverting enzyme inhibitor（ACEI). The MRA group was treated with Spironolactone combined with routine therapy while the nonMRA group treated only with Spironolactone. Twentyfour hours and 1 month after AMI, left ventricular end diastolic volume Index (LVEDVI), systolic volume index (LVESVI), all notion score index (WMSI) and ejection fraction (LVEF) were detected by ultrasonography. RESULTS At basline, no significant difference of ultrasonography indexs was seen between the two groups. At 1 month after treatment, LVEDVI, LVESVI and WMSI significantly decreased (P<005), whild LVEF increased in both MRA group and nonMRA group (P<005), but the improvements in MRA group were better than those in nonMRA group (P<005). CONCLUSION Routine therapy combined with MRA can more effectively prevent and treat LVRD in patients with AMI.

参考文献/References

［1］ Foy SG, Crozier IG, Richards AM, et al. Neurohormonal changes after acute myocardial infarction: relationships with haemodynamic indices and effects of ACE inhibition［J］. Eur Heart J, 1995, 16(6):770-778.

［2］ Sigurdsson A, Held P, Swedberg K. Short and Longterm neurohormonal activation following acute myocardial infarction［J］. Am Heart J, 1993, 126(5):1068-1076.

［3］ Oestreicher EM， MartinezVasquez D, Stone JR, et al. Aldosterone and not plasminogen activator inhibitor1 is a critical mediator of early angiotensin II/NGnitroLarginine methyl esterinduced myocardial injury［J］. Circulation, 2003, 108(20):2517-2523.

［4］ Rocha R, Stier CT Jr, Kifor I, et al. Aldosterone：a mediator of arteriopathy［J］. Endocrinology, 2000, 141(10):3871-3878.

［5］ Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by twodimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of TwoDimensional Echocardiograms［J］. J Am Soc Echocardiogy, 1989, 2(5):358-367.

［6］ Lombes M, Alfaidy N, Eugene E, et al. Prerequisite for cardiac aldosterone action: mineralocorticoid receptor and 11βhydroxysteroid dehydrogenase in the human heart［J］. Circulation, 1995, 92(2):175-182.

［7］ Pfeffer MA, Braunwald E. Ventricular remodeling after myocardial Infarction. Experimental observations and clinical implications［J］. Circulation, 1990, 81(4):1161-1172.

［8］ Zannad F, Radauceanu A. Effect of MR blockade on collagen formation and cardiovascular disease with a specific emphasis on heart failure［J］. Heart Ffail Rev, 2005, 10(1):71-78.

［9］ Host NB, Jensen LT, Bendixen PM, et al. The aminoterminal Propeptide of type III Procollagen provides new information on prognosis after acute myocardial infarction［J］. Am J Cardiol, 1995, 76(12): 869-873.

［10］Modena MG, Aventa P, Menozzi A, et al. Aldosterone inhibition limits collagen synthesis and progressive left ventricular enlargement after anterior myocardial infarction［J］. Am Heart J, 2001, 141(1):41-46.

备注/Memo

备注/Memo:
收稿日期：2007-11-13.作者简介：赵永志，副主任医师Email:zyz5636986@163.com
更新日期/Last Update: