【摘要】 目的 探讨螺内酯对急性前壁心肌梗死的梗死面积及心功能的影响。方法 将符合条件的84例急性前壁心肌梗死的患者分为螺内酯组(44例)和对照组(40例)。螺内酯组给予螺内酯80mg/d(分2次口服)。对每例患者于入院即刻、第24h、第7天、第21天行常规12导联心电图检查并记录QRS积分，同时行脑利钠肽(BNP)测定，于入院第21天进行超声多普勒检查，测定左室射血分数(LVEF)。结果 螺内酯组第21天时，QRS积分值(5.40±2.38min)显著低于对照组(5.97±2.09min，P<0.05)；BNP值(108±40ng/L)显著低于对照组(124±43ng/L，P<0.05)；LVEF(0.521±0.083)高于对照组(0.479±0.096，P<0.05)。结论 螺内酯对防止梗死的进展，改善心肌梗死后的心功能有一定作用。

    【关键词】 螺内酯；急性前壁心肌梗死；QRS积分；脑利钠肽

    Clinical evalution of spironolactone for acute anterior myocardial infarction

    ZHANG Xian,DU Wei,WANG Yun-ying.

    Department of Second Internal Medicine,The Central Hospital,Shijiazhang City,Hebei 050000,China

    【Abstract】 Objective To evaluate the effects of early treatment with spironolactone on infarct size and cardiac function in patients with acute anterior myocardial infarction.Methods 84 patients with acute anterior myocardial infarction were divided randomizedly into 2 groups: the spironolactone group(n=44) and the control group(n=40) . Patients in spironolactone group were given spironolactone 80mg each day(40mg at 8am and 40mg at 4pm). The conventional electrocardiogram was taken at the time of admission and 24h,7d,21d. Every ECG score was recorded by QRS scoring system suggested by Wagner. And brain natriuretic peptide (BNP) was determined at the time of admission and 24h,7d,21d. Left ventricle ejection fraction(LVEF)was detected by ultrasonic Doppler at 21 day after admission.Results The QRS scores of spironolactone group were lower than that of control group significantly at 21 d(5.40±2.38 vs 5.97±2.09,P<0.05). BNP level of spironolactone group was lower than that of control group significantly at 21 d too(108±40ng/L vs 124±43ng/L ......