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目的:观察急性前壁心梗患者分别使用螺内酯和氯沙坦治疗后血浆Ⅲ型前胶原(PⅢNP)、层黏连蛋白(LN)和透明质酸(HA)浓度变化。探索醛固酮受体拮抗剂和血管紧张素受体阻断剂对AMI后心室重构和胶原增生的影响。方法:132例AMI患者均为2007年5月至2008年11月于我院住院患者。其中男性82例,女50例,年龄41~65岁之间。按入院时间分为3组:氯沙坦组48例,螺内酯组48例和对照组48例。入院后(9±1)天及发病后3月、6月和12月分别测定血浆PⅢNP、LN和HA的浓度。结果:入院后(9±1)天氯沙坦组与螺内酯组患者血浆PⅢNP、LN和HA浓度无明显差异,与对照组比较明显增高,但3月、6月和12月后比较其浓度进行性降低,且对照组高于治疗组。结论:氯沙坦和螺内酯可抑制急性前壁心梗左室纤维化。
Objective: To observe the changes of plasma concentrations of type Ⅲ procollagen (PⅢNP), laminin (LN) and hyaluronic acid (HA) after spironolactone and losartan treatment in patients with acute anterior myocardial infarction. To investigate the effects of aldosterone receptor antagonists and angiotensin receptor blockers on ventricular remodeling and collagen hyperplasia after AMI. Methods: 132 AMI patients were hospitalized in our hospital from May 2007 to November 2008. There were 82 males and 50 females, aged 41-65 years old. According to the time of admission, the patients were divided into three groups: 48 in losartan group, 48 in spironolactone group and 48 in control group. Plasma concentrations of PⅢNP, LN and HA were measured at 9 ± 1 days after admission and at 3, 6 and 12 months after onset. Results: There was no significant difference in plasma PⅢNP, LN and HA concentrations between the losartan group and the spironolactone group (9 ± 1) after admission, which was significantly higher than that of the control group, but compared with that of the control group after 3, 6 and 12 months Sex decreased, and the control group than the treatment group. Conclusion: Losartan and spironolactone can inhibit left anterior fibrosis in acute anterior wall myocardial infarction.