| 中文摘要 |
過去曾有多篇的研究，認為血管張力素抑制劑可以改善心臟的功能，但大多是用雙面超音波心圖及放射性同位素攝影來觀察。本研究用靜脈注射X光顯影劑的方法，以及數位式減除攝影來觀察功能。32例病患列入研究，12例每天兩次用Captopril 50毫克，初劑量為12.5毫克在心肌梗塞後1週服用，其中有8例同時施行氣球擴張術。20例為控制組未服用 Captopril，其中有12例施行氣球擴張術。在使用藥物前施行心導管檢查以及放射性同位素左室攝影。藥物使用後6-12月施行靜脈注射X光顯影劑，以及放射性同位素左室攝影。服藥組及控制組的基本資料及冠狀動脈血流狀況均無差異。左室搏出率不論是放射性同位素法（21 * 1.1% VS 5 * 0.6%, P<0.05）或靜脈注射法（24 * 0.9% VS 6 * 0.5%, P<0.05）評估，均顯示服藥組優於控制組。左室壁瘤的改變在二者之間則無明顯的差異（-62 * 3.4% VS -38 * 2.5%, p=0.07 ）；圓周長的變化亦然。結論是：Captopril可以明顯改善心臟功能，而且可以預防左室擴大及再塑形。 |
| 英文摘要 |
The purpose of this study was to evaluate the left ventricular global function and regional wall motion in patients with acute myocardial infarction MI after angiotension converting enzyme inhibitors treatment.Thirty-seven patients were enrolled in this study, aged 39 to 70 yr old. Seventeen cases of acute anteroseptal myocardial infarction (MI) received captopril 50 mg twice a day [the initial dose was 12.5 mg], as soon as possible MI. Two cases were withdrawed due to hypotension after therapy, and 3 cases were withdrawed due to severe cough after therapy. Twelve cases were randomly selected to be the control (conservative treatment). In the captopril group, 8 cases received percuttaneous transluminal coronary angioplasty (PTCA) later. In the control group, 12 cases received PTCA. Follow-up intravenous and/or intraventricular left cine-ventriculography, as well as radionuclide ejection fraction were performed 6-12 months after the acute phase.The captopril group had a significant greater increase of ejectionfraction by both the radionuclide (21 ± 1.1 vs 5 ± 0.6, P<0.05) and intravenous (24 ± 0.9% vs 6 ± 9.5, P<0.05) left ventriculography than the control group. There were no significant changes in the dyskinetic area, volume, and left ventricular circumference, between the 2 groups.The conclusion is that coptopril per os can improved the left ventricular function and prevent the remodeling and dilatation of It ventricle after acute myocardial infarction. |
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