论文部分内容阅读
背景:许多研究已表明血管紧张素转换酶抑制剂具有独立于降压以外抗动脉粥样硬化的血管保护作用,但其机制未完全明确。目的:研究血管紧张素转换酶抑制剂对急性心肌梗死患者脂蛋白(a)和氧自由基的影响,探讨血管紧张素转换酶抑制剂抗动脉粥样硬化的机制。设计:以急性心肌梗死患者为研究对象的观察对比研究。单位:解放军总医院南二科。对象:选择2001-04/2002-08在天津港口医院心内科住院的急性心肌梗死患者35例,男19例,女16例,年龄42～75岁,平均(62±9)岁。随机分为两组,治疗组20例,对照组15例。纳入标准:符合世界卫生组织的急性心肌梗死诊断标准者;排除标准:肾功能不全、休克、低血压者及曾服血管紧张素转换酶抑制剂有过敏及明显咳嗽史者。所有患者于发病前2周未服用过血管紧张素转换酶抑制剂并且同意参加本研究。方法:治疗组于心梗后第3天晨起予依那普利5mg口服1次,若无首剂低血压反应,于心梗后第4天开始口服依那普利5mg/次,2次/d,连续2周,再予10mg/次,2次/d,连续2周。对照组不用依那普利。分别于服药前、服药后2周和4周时两组同时取血,检测血清中的脂蛋白(a)、氧自由基、三酰甘油、总胆固醇、高密度脂蛋白胆固醇和载脂蛋白(a)。主要观察指标:两组患者用药前后三酰甘油、总胆固醇、高密度脂蛋白胆固醇、载
BACKGROUND: Many studies have shown that angiotensin converting enzyme inhibitors have anti-atherogenic vascular protection independent of antihypertensive activity, but the mechanism is not completely understood. AIM: To investigate the effects of angiotensin converting enzyme inhibitors on lipoprotein (a) and oxygen free radicals in patients with acute myocardial infarction and to explore the mechanism of angiotensin converting enzyme inhibitors against atherosclerosis. Design: A comparative study of patients with acute myocardial infarction. Unit: South Second Division of PLA General Hospital. PARTICIPANTS: Thirty - five patients with acute myocardial infarction who were hospitalized in Department of Cardiology, Tianjin Port Hospital between April 2001 and August 2002 were selected, including 19 males and 16 females, aged from 42 to 75 years with an average of (62 ± 9) years. Randomly divided into two groups, treatment group 20 cases, control group 15 cases. Inclusion criteria: in line with the WHO diagnostic criteria for acute myocardial infarction; Exclusion criteria: renal insufficiency, shock, hypotension and who have served angiotensin-converting enzyme inhibitors have a history of allergies and significant cough. All patients received no angiotensin converting enzyme inhibitors 2 weeks prior to onset and agreed to participate in this study. Methods: The treatment group received enalapril 5mg orally once daily on the third day after myocardial infarction. If there was no first hypotensive reaction, enalapril 5mg / time and 2 times / d for 2 weeks, then 10mg / time, 2 times / d, for 2 weeks. The control group did not use enalapril. Blood samples were collected before treatment, 2 weeks and 4 weeks after treatment, and serum levels of lipoprotein (a), oxygen free radicals, triglyceride, total cholesterol, high density lipoprotein cholesterol and apolipoprotein a). MAIN OUTCOME MEASURES: Before and after treatment, triglyceride, total cholesterol, high density lipoprotein cholesterol,