摘要
目的 :观察急性心肌梗死早期应用血管紧张素转换酶抑制剂治疗对血管内皮依赖性舒张功能和血浆纤溶平衡的影响。方法 :采用高分辨超声技术和发色底物显示法 ,检测 3 4例急性心肌梗死患者和 3 0例无冠心病患者 (对照组 )肱动脉内皮依赖性舒张功能和血浆组织型纤溶酶原激活物 (t PA)及其抑制物 (PAI)。应用随机编码将 3 4例急性心肌梗死患者分为福辛普利组和常规治疗组 ,治疗 8周后复测其肱动脉内皮依赖性舒张功能和血浆t PA和PAI活性。结果 :急性心肌梗死患者肱动脉内皮依赖性舒张功能 (3 8± 2 3 ) %较对照组 (9 5± 3 2 ) %明显降低 ,血浆t PA活性显著降低和PAI活性明显增加 ,有非常显著性差异 (P均 <0 0 1)。福辛普利治疗 8周后 ,肱动脉内皮依赖性舒张功能(9 45± 3 2 0 ) %与治疗前基础水平 [(3 5 2± 2 70 ) % ,P <0 0 1]、常规治疗后 [(4 60± 2 80 ) % ,P <0 0 5 ]相比有显著改善 ;血浆纤溶活性也有明显改善 (t PA :0 49± 0 2 0IU /mlvs 0 2 8± 0 15IU /ml,P <0 0 1和 0 3 2± 0 15IU/ml,P <0 0 5 ;PAI :0 3 6± 0 12AU /mlvs .0 5 3± 0 2 5AU/ml,P <0 0 1和 0 45± 0 0 9AU /ml,P <0 0 5 ) ,均有显著性差异。结论 :急性心肌梗死患者内皮依赖性舒张功能明显减退 ;
Objective:To investigate the effects of fosinopril on the endothelium dependent vasodilatation function and fibrinolytic system in patients with acute myocardial infarction (AMI). Methods:With high resolution ultrasound,the endothelium dependent relaxing function of brachial arteries,tissue type plasminogen activator (t PA) activity and plasminogen activator inhibitor (PAI) activity were measured in 34 patients with AMI and in 30 control subjects The patients were randomly divided into two groups:fosinopril and control Eight weeks after treatment,the endothelium dependent relaxing function,t PA and PAI activity were measured. Results:In patients with AMI,flow mediated vasodilatation (3 8±2 3)% was much reduced compared with that in the control subjects (9 5±3 2)%( p <0 01).After fosinopril therapy,flow mediated vasodilatation was improved (9 45±3 20)% compared with those at the baseline (3 52±2 70)% ( p <0 01) and after conventional therapy (4 60±2 80)% ( p <0 05); the serum t PA activity was markedly increased (0 49±0 20 IU/ml vs 0 28±0 15 IU/ml, p <0 01 and 0 32±0 15 IU/ml, p <0 05),but PAI activity was decreased (0 36±0 12 AU/ml vs 0 53±0 25 AU/ml, p <0 01 and 0 45±0 09 AU/ml, p <0 05). Conclusion:Fosinopril may improve impaired endothelium dependent vasodilatation and fibrinolytic system dysfunction in patients with AMI.
出处
《中国循环杂志》
CSCD
北大核心
2002年第3期180-182,共3页
Chinese Circulation Journal
基金
吉林省重点科技项目子课题 (0 0 1 1 5)
关键词
急性心肌梗死
血管内皮功能
福辛普利
干预作用
Myocardial infarction
Endothelium,vascular
Fibrinolytic function
Fosinopril
