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目的观察应用血管紧张素转换酶抑制剂(ACEI)咪达普利治疗对非高血压急性心肌梗死(AMI)患者心功能的影响。方法选取2012年10月-2013年10月于医院诊断为AMI且无高血压的患者70例,分为治疗组和对照组各35例,对照组给予内科基础治疗,治疗组在基础治疗上给予咪达普利5mg每天1次口服。入院24h及治疗30d后测定患者舒张末期容积指数(EDVI)、左室射血分数(LVEF)。结果入院24h 2组患者心功能指标比较无统计学差异;治疗30d后,2组患者心功能指标均较治疗24h时明显好转,差异有统计学意义(P<0.05);并且治疗组心功能EDVI(46.58±4.72)ml/m2、LVEF(53.5±7.24)ml/m2改善好于对照组的(50.27±5.04)ml/m2、(49.12±6.37)ml/m2差异有统计学意义(P<0.05)。治疗期间无明显不良心血管事件发生。结论血压正常的急性心肌梗死患者早期应用咪达普利能够改善心功能,延缓心肌重构。
Objective To investigate the effect of the application of angiotensin converting enzyme inhibitor (Imidapril) on cardiac function in patients with non-hypertensive acute myocardial infarction (AMI). Methods Seventy patients with AMI diagnosed as AMI without hypertension in our hospital from October 2012 to October 2013 were divided into treatment group (35 cases) and control group (35 cases). The control group was given basic medical treatment. The treatment group was given basic treatment Imidapril 5mg orally daily. After admission for 24 hours and after 30 days of treatment, the end-diastolic volume index (EDVI) and left ventricular ejection fraction (LVEF) were measured. Results There was no significant difference in cardiac function between the two groups at 24 hours after admission. After 30 days of treatment, the cardiac function indexes in two groups were significantly improved compared with those at 24 hours after treatment (P <0.05) (46.58 ± 4.72) ml / m2, LVEF (53.5 ± 7.24) ml / m2 was significantly better than that of the control group (50.27 ± 5.04 ml / m2, 49.12 ± 6.37 ml / m2 ). No significant adverse cardiovascular events occurred during the treatment. Conclusion Early application of Imidapril in patients with normotensive acute myocardial infarction can improve cardiac function and delay myocardial remodeling.