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目的观察缬沙坦和福辛普利对急性心肌梗死(AMI)患者,左心室重塑(LVRM)的治疗效应并进行比较。方法 AMI患者75例,随机分为3组。缬沙坦组25例,福辛普利组26例,对照组24例。对照组给予长效硝酸酯类、肠溶阿司匹林、肝素?β-受体阻滞剂、他汀等常规治疗;缬沙坦组在常规治疗基础上加用缬沙坦80mg口服,1次/d,福辛普利组在常规治疗基础上加用福辛普利20mg口服,1次/d。分别在入院第1天、14天、6个月时采用超声心动图,测定左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVDs)、左心室射血分数(LVEF)并进行比较。结果对照组14天及6个月时LVDd、LVDs较基础值增加,有显著性差异(P<0.05);缬沙坦组与福辛普利组LVDd、LVDs变化无显著性差异(P>0.05);福辛普利组咳嗽发生率11.5%?缬沙坦组无1例发生副反应。结论缬沙坦与福辛普利具有相似的抗左心室重塑的治疗效果缬沙坦组耐受性更好。
Objective To observe and compare the therapeutic effects of valsartan and fosinopril on patients with acute myocardial infarction (AMI) and left ventricular remodeling (LVRM). Methods 75 patients with AMI were randomly divided into three groups. Valsartan group 25 cases, fosinopril group 26 cases, control group 24 cases. Control group was given long-acting nitrates, enteric-coated aspirin, heparin? -blockers, statins and other conventional treatment; valsartan group on the basis of conventional treatment with valsartan 80mg orally, once / d, Fosinopril group on the basis of conventional treatment plus fosinopril 20mg orally, 1 / d. Left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs) and left ventricular ejection fraction (LVEF) were measured by echocardiography on the first day, 14 days and 6 months after admission. Results The LVDd and LVDs in control group increased significantly at 14th and 6th month (P <0.05), but there was no significant difference between LPS and LVDs in valsartan group and fosinopril group (P> 0.05 ). The incidence of cough in fosinopril group was 11.5%. No side effects occurred in 1 patient in valsartan group. Conclusion Valsartan and fosinopril have similar anti-LV remodeling efficacy in valsartan group.