摘要
目的探究不同剂量培哚普利治疗心肌梗死后心力衰竭的疗效及不良反应。方法选取2018年4月至2019年4月本院收治的80例心肌梗死后心力衰竭患者作为研究对象,依据不同剂量培哚普利分为常规剂量组(4 mg)和高剂量组(8 mg),每组40例。比较两组血压、6 min步行距离(6MWT)、血生化指标、心功能、心肌能量消耗指标。结果治疗后,两组收缩压、舒张压均低于治疗前,6MWT均大于治疗前,且高剂量组收缩压、舒张压均低于常规剂量组,6MWT大于常规剂量组,差异均有统计学意义(P<0.05)。治疗后,两组心型脂肪酸结合蛋白(H-FABP)、脑钠肽(BNP)均低于治疗前,且高剂量组H-FABP、BNP均低于常规剂量组,差异有统计学意义(P<0.05);两组治疗前后血清血肌酐(SCr)、血钾水平比较差异无统计学意义。治疗后,两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均低于治疗前,左室射血分数(LVEF)均高于治疗前,且高剂量组LVEDD、LVESD均低于常规剂量组,LVEF高于常规剂量组,差异有统计学意义(P<0.05);两组治疗前后左室缩短率(LVFS)比较差异无统计学意义。治疗后,两组左室收缩末期向室壁应力(cESS)、心肌能量消耗水平(MEE)均低于治疗前,且高剂量组低于常规剂量组(P<0.05)。结论高剂量培哚普利治疗心肌梗死后心力衰竭较常规剂量更能有效减少患者不良反应的发生,提升临床疗效,值得临床推广应用。
Objective To compare the efficacy and adverse reactions of different doses of perindopril in the treatment of heart failure after myocardial infarction.Methods 80 patients with heart failure after myocardial infarction who were admitted to our hospital from April 2018 to April2019 were selected as the research subjects,and they were divided into conventional dose group(4 mg)and high dose group(8 mg)according to different doses of perindopril,with 40 cases in each group.The blood pressure,6-min walking test(6MWT),blood biochemical indexes,cardiac function and myocardial energy consumption indexes were compared between the two groups.Results After treatment,the systolic blood pressure and diastolic blood pressure in the two groups were lower than those before treatment,and the 6MWT was greater than that before treatment,and the systolic blood pressure and diastolic blood pressure in the high dose group were lower than those in the conventional dose group,and the 6MWT was greater than that in the conventional dose group,and the difference was statistically significant(P<0.05).After treatment,heart-type fatty acid-binding protein(H-FABP)and brain natriureticpe ptide(BNP)in both groups were lower than before treatment,and serum potassium was higher than before treatment,and H-FABP and BNP in high dose group were lower than those in conventional dose group,and serum potassium was higher than that in conventional dose group,and the difference was statistically significant(P<0.05);there was no significant difference in serum serum creatinine(SCr)levels between the two groups before and after treatment.After treatment,left ventricular end-diastolic dimension(LVEDD)and left ventricular end-systolic dimension(LVESD)in both groups were lower than before treatment,and left ventricular ejection fraction(LVEF)was higher than before treatment,and LVEDD and LVESD in high dose group were lower than those in conventional dose group,and LVEF was higher than that in conventional dose group,and the difference was statistically significant(P<0.05);there was no significant difference in left ventricular fractional shortening(LVFS)between the two groups before and after treatment.After treatment,circumferential end-systolic wall stress(cESS)and myocardial energy expenditure(MEE)in both groups were lower than those before treatment,and the high dose group was lower than the conventional dose group(P<0.05).Conclusion High dose perindopril in the treatment of heart failure after myocardial infarction can more effectively reduce the occurrence of adverse reactions and improve clinical efficacy than conventional doses,which is worthy of clinical application.
作者
张玉平
吴洪兵
ZHANG Yuping;WU Hongbing(Department of Cardiovascular Medicine,Xinren People's Hospital,Qianxinan,Guizhou,562300,China)
出处
《当代医学》
2022年第11期40-43,共4页
Contemporary Medicine
关键词
不同剂量
培哚普利
心肌梗死后心力衰竭
心肌能量消耗
Different doses
Perindopril
Heart failure after myocardial infarction
Myocardial energy consumption
