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目的 观察洛沙坦和培哚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 6 5例 ,随机分为 3组。洛沙坦组 2 2例 ,培哚普利组 2 2例 ,对照组 2 1例。对照组仅给予硝酸酯类、肠溶阿司匹林、肝素等常规治疗 ;洛沙坦组在常规治疗基础上加用洛沙坦 2 5mg口服 ,每日 1次 ;培哚普利组在常规治疗基础上加用培哚普利 4mg口服 ,每日 1次。分别在入院后第 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 .0 5 ) ;洛沙坦组与培哚普利组 14天及 6个月时LVDd、LVDs与基础值比较轻度增加 ,与对照组比较明显缩小 ,有显著性差异 (P <0 .0 5 ) ;洛沙坦组与培哚普利组LVDd、LVDs变化无显著性差异 (P >0 .0 5 )。培哚普利组咳嗽发生率 18% ,洛沙坦组无 1例发生副反应。结论 洛沙坦与培哚普利具有相似的抗左心室重塑的治疗效应 ,洛沙坦耐受性更好
Objective To observe and compare the therapeutic effects of losartan and perindopril in patients with acute myocardial infarction (AMI) and left ventricular remodeling (LVRM). Methods Sixty-five AMI patients were randomly divided into three groups. There were 22 cases in losartan group, 22 cases in perindopril group and 21 cases in control group. The control group was given only nitrates, enteric-coated aspirin, heparin and other conventional treatment; Losartan group on the basis of conventional treatment plus losartan 25mg orally, once daily; perindopril group on the basis of routine treatment Add perindopril 4mg orally, once daily. The 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, the 14th day and the 6th month after admission. . Results The LVDd and LVDs in the control group increased significantly at 14 and 6 months (P <0.05), while the LVDd and LVDd in the Losartan and Perindopril groups at 14 and 6 months LVDs slightly increased compared with the baseline value, significantly reduced compared with the control group, there was a significant difference (P <0. 05); Losartan group and perindopril group LVDd, LVDs no significant difference (P> 0 .0 5). The incidence of cough in the perindopril group was 18%, and none in the Losartan group. Conclusions Losartan and perindopril have similar therapeutic effects against left ventricular remodeling and losartan is better tolerated