作　　者： (李大鹏）; (孙党辉）; (魏林）; (于熙莹）; (那世敬）;

机构地区： 黑龙江省哈尔滨市第一医院,黑龙江哈尔滨150010

出　　处： 《海南医学院学报》 2017年第13期1755-1758,共4页

摘　　要： 目的:探讨培哚普利治疗心肌梗死后心力衰竭患者的临床疗效及患者心肌能量消耗的影响。方法:选取本院收治的心肌梗死后心力衰竭患者87例为研究对象,所有患者均予以培哚普利治疗,据患者长期口服剂量分为常规剂量组(n=43,培哚普利4mg/d)及高剂量组(n=44,培哚普利8mg/d),2组均连续治疗6个月。比较治疗前后2组患者血压、血生化指标变化;检测并比较治疗前后2组患者心功能指标及心肌能量消耗指标的变化;统计2组治疗6个月及治疗1年时的6 MWT。结果:与治疗前比较,治疗后2组血浆BNP及H-FABP水平、LVEDD、LVESD、MEE及cESS均明显降低,且高剂量组显著低于低剂量组(P<0.01);2组LVEF及FS均明显增大,且高剂量组显著大于常规剂量组(P<0.01);高剂量组血钾水平较治疗前显著升高(P<0.01),但治疗后与常规剂量组无显著差异(P>0.05);2组SBP、DBP、Scr水平均无显著变化(P>0.05);高剂量组患者治疗6个月及治疗1年时6MWT距离均显著大于常规剂量组(P<0.01)。结论:高剂量培哚普利可更显著降低心肌梗死后心力衰竭患者血浆BNP及H-FABP水平,抑制心室重构,促进患者心脏收缩功能的恢复,同时降低患者心肌能耗水平,且不会影响患者血压、血钾及肾功能等,疗效显著优于低剂量培哚普利且具有一定的安全性。 Objective：To explore the clinical efficacy of perinodopril in the treatment of heart failure in patients after myocardial infarction and effect on the myocardial energy consumption.Methods：A total of 87 patients with heart failure after myocardial infarction who were admitted in our hospital from August,2014 to October,2015 were included in the study and divided into the routine dose group（n=43,perinodopril 4mg/d）and high dose group（n=44,perinodopril 8mg/d）according to the long-term oral dose.All the patients were given perinodopril,continuously for 6months.The changes of blood pressure and serum biochemical indicators before and after treatment in the two groups were compared.The changes of cardiac function indicators and myocardial energy consumption indicators before and after treatment in the two groups were compared.6MWT 6months and 1year after treatment in the two groups was calculated.Results：The plasma BNP and H-FABP levels,LVEDD,LVESD,MEE,and cESS after treatment in the two groups were significantly reduced when compared with before treatment,and those in the high dose group were significantly lower than those in the low dose group（P〈0.01）.LVEF and FS after treatment in the two groups were significantly increased,and those in the high dose group were significantly greater than those in the routine dose group（P〈0.01）.The seurm potassium level after treatment in the high dose group was significantly elevated when compared with before treatment（P〈0.01）,but was not significantly different from that in the routine dose group（P〈0.05）.SBP,DBP,and Scr levels after treatment in the two groups were not significantly changed（P〈0.05）.6MWT 6months and 1year after treatment in the high dose group was significantly greater than that in the routine dose group（P〈0.01）.Conclusions：Perinodopril in high dose can significantly reduce the plasma BNP and H-FABP levels in patients with heart failure after myocardial infarction,inhibit the ventricular remodeling,promote the rec

关 键 词： 心肌梗死 心力衰竭 培哚普利 心功能 心肌能量消耗