大剂量缬沙坦治疗急性心肌梗死后心室重构的临床效果

目的探讨大剂量缬沙坦治疗急性心肌梗死后心肌重构的临床效果。方法纳入急性心肌梗死患者73例,患者入院后采用随机数表法将患者分为对照组(给予常规剂量的缬沙坦,n=36,80 mg/日)和观察组(给予大剂量的缬沙坦,n=37,160 mg/日),比较两组左心室结构参数,包括左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、室间隔厚度(IVSD)和左室后壁厚度(LVPWD)以及左心室功能参数,包括左心室收缩末容量(LVESV)、左心室舒张末容量(LVEDV)、左心室射血分数(LVEF)、心输出量(CO)的差异。结果两组患者经治疗后左心室结构(LVESD、LVEDD、IVSD及LVPWD)、左心功能(LVESV、LVEDV、LVEF及CO)与治疗前比较均有显著改善(P均0.05);与对照组治疗后相比,观察组改善更为显著(P均0.05);观察组患者不良反应发生率为13.5%,与对照组8.1%相比差异无统计学意义(P0.05)。结论大剂量缬沙坦治疗急性心肌梗死可显著改善患者的梗死后心室重构。

Curative effect of high-dose valsartan on ventricular remodeling after acute myocardial infarction

Objective To discuss the curative effect of high-dose valsartan on ventricular remodeling after acute myocardial infarction （AMI）. Methods AMI patients （n=73） were randomly divided into control group treated with normal-dose valsartan （80 mg/d, n=36） and observation group treated with high-dose valsartan （160 mg/d, n=37）. The differences in the parameters of left ventricular structure including LVESD, LVEDD, IVSD and LVPWD, and parameters of left ventricular function including LVESV, LVEDV, LVEF and CO were compared between two groups. Results In two groups, LVESD, LVEDD, IVSD, LVPWD, LVESV, LVEDV, LVEF and CO were all improved after treatment （all P〈0.05）. Compared with control group after treatment, the above improvements were more significant in observation group （all P〈0.05）. The incidence of adverse reactions was 13.5%in observation group and 8.1%in control group （P〉0.05）. Conclusion High-dose valsartan can significantly ameliorate ventricular remodeling after AMI.