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目的比较美托洛尔联合卡托普利与单用卡托普利对急性心肌梗死(AM I)后左心室重构的效果。方法将122例AM I患者随机分为美托洛尔联合卡托普利组(52例)、卡托普利组(50例)和常规治疗组(20例),分别于治疗后1周、6个月采用心脏多普勒超声测定左心室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末内径(LVEDd),计算左室重量指数(LVM I),同时测定左室射血分数(LVEF)及舒张早期左室充盈最大速率(E峰)与心房收缩期最大速率(A峰)。结果美托洛尔联合卡托普利组和单用卡托普利组与常规治疗组比较均可使IVST、LVPWT变薄(P<0.01),LVDd缩小(P<0.01),LVM I降低(P<0.01)。美托洛尔联合卡托普利组和单用卡托普利组均可增加LVEF、降低A/E峰比值,与常规治疗组比较,1周时P<0.05,6个月时P<0.01。美托洛尔联合卡托普利对心率较快的患者尤为适用。结论美托洛尔联合卡托普利具有良好的防治AM I后左室重构的效果。
Objective To compare the effects of metoprolol combined with captopril and captopril alone on left ventricular remodeling after acute myocardial infarction (AMI). Methods A total of 122 patients with AMI were randomly divided into two groups: metoprolol plus captopril (52 cases), captopril (50 cases) and conventional treatment group (20 cases) Six months later, left ventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular end-diastolic diameter (LVEDd) were measured by Doppler echocardiography, left ventricular mass index (LVM I) The ejection fraction (LVEF) and the maximum rate of left ventricular filling (E peak) and the maximum atrial systolic velocity (A peak) during early diastole were measured. Results Compared with the conventional treatment group, both metoprolol combined captopril group and captopril alone group decreased IVST and LVPWT (P <0.01), LVDd decreased (P <0.01), LVM I decreased P <0.01). Metoprolol combined captopril group and captopril alone group can increase LVEF, reduce peak A / E ratio, compared with the conventional treatment group, P <0.05 at 1 week P <0.01 at 6 months . Metoprolol combined with captopril is particularly suitable for patients with faster heart rate. Conclusion Metoprolol combined with Captopril has a good effect of prevention and treatment of left ventricular remodeling after AMI.