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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2010年第4期

页码:

547-550

栏目:

临床研究

出版日期:

2010-06-10

文章信息/Info

Title:

Effects of valsartan and spironolactone on collagen metabolism and heart function in patients with acute myocardial infarction with aneurysm

作者:

胡少东¹; 傅向华²

1.首都医科大学宣武医院心脏科，北京100053；2.河北医科大学第二医院心内科，河北 石家庄 050051

Author(s):

HU Shao-dong¹;  FU Xiang-hua²

1.Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; 2.Department of Cardiology, Second Affiliated Hospital, Hebei Medical University. Shijiazhuang 050051, Hebei, China

关键词:

心肌梗死; 急性; 胶原; 心功能; 室壁瘤

Keywords:

acute myocardial infarction;  collagen;  heart function;  left ventricular aneurysm

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的: 研究缬沙坦及合用安体舒通对经再灌注治疗的急性心肌梗死患者血清胶原水平和心功能的影响。方法: 首次急性前壁心肌梗死伴室壁瘤患者70例，随机分为缬沙坦组、合用药组（缬沙坦合用安体舒通），在治疗后1周、2周、12周测定血清Ⅰ型前胶原羧基末端肽（PⅠCP）和Ⅲ型前胶原氨基末端肽（PⅢNP）浓度；并在治疗后2周、12周进行二维超声心动图检查。结果: 12周时合用药组血清PⅢNP、血清PⅠCP较缬沙坦组明显降低(P<0.05)。合用药组的舒张末期容积指数、收缩末期容积指数、局部室壁运动指数、左室射血分数及左室质量指数较缬沙坦组明显改善(P<0.05)。结论: 缬沙坦能够阻抑急性心肌梗死伴室壁瘤患者的胶原合成，改善心室收缩和舒张功能；合用药组的作用优于单用缬沙坦, 显著改善心室收缩和舒张功能。

Abstract:

AIM: To evaluate the effects of valsartan and spironolactone on collagen metabolism and heart function in patients with acute myocardial infarction (AMI). METHODS: Patients with first anterior AMI with aneurysm confirmed by left ventriculography were divided into two groups: 1) valsartan and spironolactone group, and 2) valsartan group. Serum PIII NP and PI CP were measured at 1, 2 and 12 weeks after onset of AMI. At 2 and 12 weeks after onset of AMI, the parameters of left ventricular end diastolic volume index (LVEDVI), left ventricular end systolic volume index (LVESVI), left ventricular ejection fraction (LVEF) and regional wall movement index (RWMI) were measured. RESULTS: At 12 weeks, serum PIIINP and PICP in valsartan and spironolactone group were significantly lower than in valsartan group (P<0.05), and the parameters of left ventricular function were better improved in valsartan and spironolactone group compared with valsartan group. CONCLUSION: Valsartan helps to reverse the formation of collagen and improve systolic and diastolic function in post-myocardial infarction. Combined therapy with valsartan and spironolactone is more effective than monotherapy and markedly improved systolic and diastolic function in post-myocardial infarction.

参考文献/References

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［11］Tsukashita M, Marai A, Nishina T, et al. Spironolactone alleviates late cardiac remodeling after left ventricular restoration surgery［J］. The Journal of Thoracic and Cardiovascular surgery, 2008, 136(1):58-64.

备注/Memo

备注/Memo:

收稿日期：2009-03-16.作者简介：胡少东，主治医师，博士Email：hsdong2008@126.com

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更新日期/Last Update: 2010-05-20