在心肌梗塞后早期预防左心室功能障碍,通过抑制血管酶转化酶
1Department of Medicine, University of Auckland School of Medicine, Auckland Hospital, New Zealand.
Lancet (London, England)
|April 13, 1991
概括
在心肌梗塞后早期治疗卡波普里尔可以防止左心室扩张. 这种干预改善了喷射分数和减少了末缩体积,在预防心脏病发作后心脏重塑方面提供了显著的好处.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 左心室功能障碍是心肌梗塞后的常见并发症.
- 众所周知, ангиотензин转化酶 (ACE) 抑制剂可以改善心脏功能,如果在心肌梗塞后晚些时候开始使用.
研究的目的:
- 为了研究早期干预的好处,使用卡普托普利,一种ACE抑制剂,在Q波心肌梗塞后24-48小时内开始.
- 为了确定早期的ACE抑制是否与后期治疗相比,在防止左心室重塑方面具有更大的益处.
主要方法:
- 一项双盲随机研究,涉及100名患有Q波心肌梗塞但没有临床心力衰竭的患者.
- 患者从症状出现后24-48小时开始接受卡普托普里尔 (50毫克每天两次) 或安慰剂.
- 在3个月的时间内,使用二维心声谱评估左心室体积和射出分数.
主要成果:
- 安慰剂组显示左心室末端透缩和末端静缩体积显著增加,喷射分数没有变化.
- 卡普托普里尔组显示,末缩体积显著减少,喷射分数显著增加.
- 与安慰剂相比,卡普托普里尔组的射出分数得到了4.6%的改善 (p < 0.0001).
结论:
- 早期使用卡普托普利的治疗有效地防止Q波心肌梗塞后的左心室扩张.
- 早期卡普托普里尔干预的好处在1个月内就显而易见,并在停止治疗后持续.
- 早期的ACE抑制是管理心肌梗塞后心脏重塑的有价值策略.
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