Di Pasquale P, Barone G, Paterna S, Cannizzaro S, Giubilato A
G.F. Ingrassia Hospital, Palermo, Italy.
Drugs Exp Clin Res. 1990;16(11):581-9.
Studies on experimental animals indicate that ACE-inhibition might play an important role in coronary flow regulation and reperfusion damage limitation by alleviating non-irreversible myocardial damage and reducing Hyperkinetic Ventricular Arrhythmias (HVA) caused by reperfusion. This suggests the usefulness of captopril, an ACE-inhibitor containing the -SH group, in combination with systemic thrombolysis or mechanical revascularisation. The study was performed on seventy-two patients admitted to the hospital within 4 h of the onset of major cardiac symptoms due to Unstable Angina Pectoris (UAP) or Acute Myocardial Infarction (AMI). They were randomized either to treatment with oral captopril 15 min before thrombolysis (thirty-seven patients), or to thrombolysis followed by oral captopril on day 3-4 (thirty-five patients). In the early captopril-treated patients, a significant reduction in early arrhythmias was observed within 2 h, a lower incidence of late arrhythmias and a faster normalisation of necrosis enzymes. These data provide further evidence for the useful role of early captopril treatment in acute myocardial infarction.
对实验动物的研究表明，血管紧张素转换酶（ACE）抑制作用可能在冠状动脉血流调节以及通过减轻不可逆性心肌损伤和减少再灌注所致的高动力性室性心律失常（HVA）来限制再灌注损伤方面发挥重要作用。这提示含巯基的ACE抑制剂卡托普利与全身溶栓或机械性血管重建联合使用可能有效。该研究针对因不稳定型心绞痛（UAP）或急性心肌梗死（AMI）出现主要心脏症状后4小时内入院的72例患者进行。他们被随机分为两组，一组在溶栓前15分钟口服卡托普利治疗（37例患者），另一组在第3 - 4天进行溶栓后口服卡托普利（35例患者）。在早期接受卡托普利治疗的患者中，2小时内早期心律失常显著减少，晚期心律失常发生率较低，坏死酶更快恢复正常。这些数据进一步证明了早期卡托普利治疗在急性心肌梗死中的有益作用。
