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目的 :对比血管紧张素II受体拮抗剂 (AIIA)氯沙坦和血管紧张素转换酶抑制剂 (ACEI)卡托普利对前壁急性心肌梗死 (AMI)后右室功能的影响。方法 :将 75例首次前壁AMI患者随机分为常规治疗组 (15例 )、卡托普利组 (30例 )和氯沙坦组 (30例 ) ,并于AMI后 1、4、2 8周分别行平衡法核素心室造影 (ERNA)及心室相位分析 (PA) ,测定右室收缩功能 (RVSF)、右室舒张功能 (RVDF)和右室收缩同步性功能 (RVSS) ,了解两药物对AMI后右室功能的影响。结果 :①AMI后 2 8周时与常规治疗组比较 ,氯沙坦组右室射血分数和右室平均充盈率分别增加 12 .19%和 19.12 %(P <0 .0 5 ) ,右室高峰射血率时间、右室高峰充盈率时间分别降低 16 .2 1%(P <0 .0 1)、2 4.38%(P <0 .0 5 ) ,且氯沙坦组与卡托普利组差异无显著性意义。②AMI后 2 8周时 ,氯沙坦组和卡托普利组相位延迟减轻 ,氯沙坦组右室相角程、半高宽和峰相位标准差分别较常规治疗组降低 13.92 %、2 3.12 %和2 4.84%(P <0 .0 1,<0 .0 5和 <0 .0 1)。结论 :氯沙坦能明显减轻前壁AMI后右室功能的下降 ,提高右室收缩的同步性 ,且其效果与卡托普利相近。
AIM: To compare the effects of losartan and angiotensin converting enzyme inhibitor (ACEI) captopril on right ventricular function after anterior myocardial infarction (AMI) in patients with angiotensin II receptor blocker (AIIA). Methods: Seventy-five AMI patients were randomly divided into routine treatment group (n = 15), captopril group (n = 30) and losartan group (n = 30) Week, respectively. The balance of right ventricular systolic function (RVSF), right ventricular diastolic function (RVDF) and right ventricular systolic synchronicity (RVSS) were measured by equilibrium method of radionuclide ventriculography (ERNA) and ventricular phase analysis Right ventricular function after AMI. RESULTS: At 18 weeks after AMI, right ventricular ejection fraction and right ventricular filling fraction increased by 12.19% and 19.12% (P <0.05) in right ventricular peak The time of ejection rate and the time of peak right ventricular filling rate decreased by 16.21% (P <0.01) and 2.38% (P <0.05), respectively, and losartan group and captopril group No significant difference between the significance. ② At 28 weeks after AMI, the phase delay in losartan group and captopril group was reduced, and the standard deviation of phase angle, half height width and peak phase in losartan group were decreased by 13.92% and 2.12 % And 2 4.84% (P <0 .01, <0 .0 5 and <0 .01). CONCLUSION: Losartan can significantly reduce the decline of right ventricular function after AMI in anterior wall and improve the synchrony of right ventricular contraction, and its effect is similar to that of captopril.