小剂量螺内脂对急性前壁心肌梗死患者血清脑利钠肽水平和左室重构的影响探讨
柯英利，张红星
（1.西安市民航西安医院急诊科，陕西 西安，710082；2.西安市西安高新医院神经内三科，陕西 西安，710075）
浏览次数：107次 下载次数：340次
摘要：
目的 研究小剂量螺内脂对急性前壁心肌梗死患者血清脑利钠肽水平和左室重构的影响。方法 选择于我院就诊的83例急性前壁心肌梗死患者为研究对象，随机将患者分为常规组和螺内脂组。常规组患者采取常规治疗，螺内脂组患者在常规 组治疗方案基础上增加20mg螺内酯进行治疗。比较两组患者的临床疗效、不良反应发生率及干预前、后患者血清脑利钠肽 水平和左室重构相关指标的差异。结果螺内脂组患者的总有效率为95.24%，明显高于对照组患者的75.61%（P<0.05）；两组患者治疗过程中均未发生不良反应（P>0.05）；干预后，两组患者的血清脑利钠肽水平和左室重构相关指标均明显优于干预前，且螺内脂组患者血清脑利钠肽水平和左室重构相关指标明显优于常规组（P<0.05）。结论 小剂量螺内脂用于治疗急性前壁心肌梗死，对患者血清脑利钠肽水平和左室重构影响大，可有效降低血清脑利钠肽水平和左室舒张末期内径，促进左室射血分数的升高，对患者预后有益，值得推广。
关键词：小剂量螺内脂；急性前壁心肌梗死；血清脑利钠肽水平；左室重构
中图分类号：R542.22文献标志码：A文章编号：2096-1413(2017)04-0016-02
The effect of low doses of spironolactone on serum levels of brain natriuretic peptide and
left ventricular remodeling in patients with acute anterior wall myocardial infarction
KE Ying-li, ZHANG Hong-xing
(1. Department of Emergency, Civil Aviation Xi'an Hospital, Xi'an 710082; 2. 3rd Department of Neurology, Xi'an Gaoxin Hospital, Xi'an 710075, China)
ABSTRACT: Objective To study the effect of low doses of spironolactone on serum levels of brain natriuretic peptide and left ventricular remodeling in patients with acute anterior wall myocardial infarction. Methods Eighty three cases of patients with acute anterior wall myocardial infarction admitted in our hospital were collected as the study objects, and were randomly divided into conventional group and spironolactone group. The conventional group was given conventional treatment, while the spironolactone group was treated with 20 mg spironolactone on the basis of the conventional group. The clinical effect, incidence rate of adverse reactions and the difference on serum levels of brain natriuretic peptide and left ventricular remodeling before intervention and after intervention were compared. Results The total effective rate of spironolactone group was 95.24%, which was higher than 75.61% of the control group (P<0.05). No adverse reaction occurred during the treatment (P>0.05). After intervention, the serum levels of brain natriuretic peptide and left ventricular remodeling indicators were better than those before treatment, and those of the spironolactone group were obviously better than the conventional group (P<0.05). Conclusion Low doses of spironolactone has significant effect on the serum levels of brain natriuretic peptide and left ventricular remodeling in patients with acute anterior wall myocardial infarction. It can effectively reduce the serum levels of brain natriuretic peptide and left ventricular end-diastolic diameter, and can improve the left ventricular ejection fraction. It is benefit to the prognosis for patients and worthy of popularization.
KEYWORDS: low doses of spironolactone; acute anterior wall myocardial infarction; serum levels of brain natriuretic peptide; left ventricular remodeling
参考文献：
[1] 张敏.小剂量螺内脂对急性前壁心肌梗死患者血清脑利钠肽水平和左室重构的影响[J].医药前沿,2016,6(2):207-208.
[2] 马京炬,亢惠兰,郑跃星,等.小剂量螺内酯抑制急性前壁心肌梗死患者的左室重构[J].中国心血管病研究,2011,9(6):423-425.
[3] 李亚芹,王乾一,徐占稳,等.早期应用螺内酯对急性心肌梗死患者心功能及心室重构的影响[J].岭南心血管病杂志,2015,21(6):755-758.
[4] ILHAN E,GUVEN TS,ALTAY S,et al.Predictive value of red cell distribution width in intrahospital mortality and postintervention throm- bolysis in myocardial infarction flow in patients with acute anterior my- ocardial infarction[J].Coron Artery Dis,2012,23(7):450-454.
[5] 王全志,杨旸,陈惠军,等.螺内脂降低大鼠心肌非梗死区MMP/ TIMP基因转录及表达[J].基础医学与临床,2013,33(3):341-345.
[6] 杨进华,梁碧波,黄十佳,等.螺内酯对心肌梗死患者IL-6及心功能的影响[J].河南大学学报:医学版,2011,30(2):116-118.
[7] NISHIZAKI F,TOMITA H,YOKOYAMA H,et al.Re-elevation of T-wave from day 2 to day 4 after successful percutaneous coronary inter原 vention predicts chronic cardiac systolic dysfunction in patients with first anterior acute myocardial infarction[J].Heart Vessels,2013,28(6): 704-713.
[8] 郭再萍,石国平,郭江宏,等.螺内酯预处理对兔非梗死区冠脉内皮 eNOS 表达及心梗后血流动力学的影响[J].东南大学学报:医学版,2010,29(5):528-531.
[9] 庞春强.急性心肌梗死合并2型糖尿病与单纯急性心肌梗死的比较[J].中国社区医师:医学专业,2013,15(7):90-91.