《中国康复理论与实践》

《中国康复理论与实践》 ›› 2010, Vol. 16 ›› Issue (5): 413-414.

• 论文 • 上一篇    下一篇

心肌梗死患者抗醛固酮治疗后心功能变化的多普勒组织成像研究

刘长福，霍霄鲲，杨庭树，智光，徐勇，韩宝石   

  1. 中国人民解放军总医院心血管内科,北京市 100853。
  • 收稿日期:2010-04-08 修回日期:1900-01-01 出版日期:2010-05-25 发布日期:2010-05-25

Cardiac Function in Patients with Myocardial Infarction Treated with Spironolactone: A Doppler Tissue Imaging Study

LIU Chang-fu, HUO Xiao-kun, YANG Ting-shu, et al.   

  1. Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2010-04-08 Revised:1900-01-01 Published:2010-05-25 Online:2010-05-25

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摘要： 目的应用多普勒组织成像（DTI）技术评价心肌梗死患者抗醛固酮治疗前后心功能的动态变化。方法130例确诊心肌梗死患者分为螺内酯组（常规治疗＋螺内酯）61例与对照组（常规治疗）69例，在入选时，治疗6个月、12个月后行DTI及常规超声心动图检查。结果治疗6个月后，螺内酯组收缩期主峰s波速度的平均值（）较治疗前增加（P＜0.05），左室射血分数（LVEF）有增加趋势但无统计学意义。治疗12个月后，螺内酯组增加（P＜0.05），LVEF也有改善（P＜0.05）。对照组患者治疗6个月和12个月后，、LVEF均无显著性差异。各组舒张早期与晚期主峰速度比（e/a）治疗前后无显著性差异（P＞0.05）。结论常规治疗联合螺内酯可改善心肌梗死患者6个月和12个月收缩功能，但未改善舒张功能。

关键词: 心肌梗死, 醛固酮拮抗剂, 多普勒组织成像, 心功能

Abstract: ObjectiveTo study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction. Methods130 patients with myocardial infarction were divided into anti-aldosterone group (spironolactone 20～40 mg/d + enalapril 10～20 mg/day, n=61) and control group (enalapril 10～20 mg/d, n=69). The echocardiogram and Doppler tissue imaging (DTI) were performed at enrolling time, and 6, 12 months after treatment. ResultsIn the anti-aldosterone group, the average mitral systolic wave (s) was significantly increased 6 months after treatment （P<0.05） to the enrolling time. LVEF and LVEDD improved 12 months after treatment （P<0.05）. In the control group, the average mitral systolic wave, LVEDD and LVEF did not significantly improve (P>0.05). Ratio of peak early to late diastolic filling velocity (e/a) was no significantly different between the anti-aldosterone group and the control group. ConclusionThe combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months, but cannot to the diastolic function.

Key words: myocardial infarction, aldosterone antagonists, Doppler tissue imaging, cardiac function