【摘要】 目的　此研究观察了对扩张型心肌病患者长期 (6个月 )应用血管紧张素转换酶抑制剂 (ACEI)对心功能和心脏大小的影响。方法　 39例心功能NYHAⅢ～Ⅳ级的扩张型心肌病患者除应用常规强心剂、利尿剂外 ,用转换酶抑制剂依那普利治疗 6个月 ,在治疗前和 6月后用超声心动图测心脏左房、左室、右室大小及射血分数 (EF)。结果　经 6个月ACEI治疗后 ,39例患者心功能有明显改善 ,EF明显增加由 (0 382 5± 0 0 945 )增加到 (0 44 91± 0 0 971) (P <0 0 1) ,39例中 2 6例除左房左室增大外同时合并右室增大。此 2 6例右室较用药前有明显缩小 ,由 (2 5 40± 7 43)mm减为 (2 1 0 1± 5 2 3)mm (P <0 0 1)。 39例左房由 (41 6 6± 7 76 )mm缩小为 (40 5 1± 8 18)mm(P >0 0 5 )无统计学差异。左室内经未见明显缩小 ,从(6 7 11± 7 99)mm减小到 (6 5 5 0± 9 5 2 )mm(P >0 0 5 )。结论　ACEI使扩张型心肌病患者心功能改善和心腔缩小。右室有明显缩小 ,而左房左室变化不明显。更多还原

【Abstract】 Objective To investigate the efficacy of long-term angiotensin converting enzyme inhibitor (ACEI) on the cardiac function and the size of heart in patients with dilated cardiomyopathy. Methods thirty-nine patients with dilated cardiomyopathy (NYHAⅢ～Ⅳ) were treated with ACEI-enalapril for 6 months, besides digoxin,diuretics. The dimension of LA, LV, RV, RA and EF were measured with Doppler echocardiography before and after 6 month therapy with ACEI. Results After 6 month therapy with enalapril: ① The cardiac function of 39 patients significantly was improved, The ejection fraction (EF) was increased from(0 382 5±0 094 5) to (0 449 1±0 097 1)( P <0 01). ②Twenty-six patient right ventricular (RV) was obviously reduced from (25 40±7 43)mm to (21 01±5 23)mm ( P >0 01). ③Left atrium (LA) was reduced from (41 66±7 76)mm to (40 51±8 81)mm ( P >0 05),and there was no significant difference. The dimension of left ventricle (LV) was not significantly reduced. Conclusion the cardiac function and cavity of dilated cardionmyopathy are improved by ACEI therapy. The dimension of right ventricle is significantly reduced.更多还原