卡维地洛对高血压伴房颤患者P波离散度的影响

Effects of carvedilol on P_(max) and P_d in essential hypertensive patients with paroxysmal atrial fibrillation

目的研究卡维地洛对高血压伴阵发性心房颤动患者P波最大时限(Pmax)和P波离散度(Pd)的影响,探讨卡维地洛对心房颤动的抗心律失常效应。方法将52例高血压伴阵发性房颤患者随机分成卡维地洛治疗组(26例)和对照组(26例),另设正常人26例为正常组。在服药前、服药3月分别测量Pmax及Pd,并观察治疗后阵发性房颤发作情况。结果高血压伴阵发性房颤者Pmax及Pd均较正常人明显延长(Pmax:128.20±8.49msvs105.20±8.21ms,p<0.05;Pd:45.89±8.92msvs29.11±8.02ms,p<0.05)。服药第3个月治疗组Pmax及Pd较治疗前明显缩短(Pmax:108.82±8.27msvs127.24±7.25ms,p<0.05;Pd:29.28±5.92msvs45.66±8.82ms,p<0.05),较对照组也明显缩短(Pmax:108.82±8.27msvs126.28±6.24ms,p<0.05;Pd:29.28±5.92msvs44.07±6.30ms,p<0.05)。治疗第3个月时,治疗组阵发性房颤发作减少12例,而对照组6例有效。结论高血压伴阵发性房颤患者Pmax、Pd较正常人增大,卡维地洛可缩短Pmax及Pd并可能减少阵发性房颤的发作。

Objective To explore antiarrhythmic effect of carvedilol by studying the impact of carvedilol on P wave dispersion （Pd） in 26 essential hypertensive patients with paroxysmal atrial fibrillation（PAF）. Methods 52 patients were randomized into carvedilol treatment group （n=26） and control group （n=26）. Pmax and Pd were measured based on the electrocardiogram at the beginning and the third month after taking medicine. Normal group （n=26） was regarded as control .Then the Pd and Pmax and PAF of 3 groups were compared. Results Pd and Pd increased significantly in patients with PAF of hypertension compared with normal group （Pmax： 128.20±8.49ms vs 105.20±8.21 ms,p 〈0.05 ; Pd ： 45.89 ±8.92ms vs 29.11 ±8.02ms ,p 〈0.05 ）. Pmax and Pd were decreased obviously in treatment group after 3 months of treatment （Pmax： 108.82±8.27ms vs 127.24±7.25ms,p〈0.05 ;Pd：29.28±5.92ms VS 45.66±8.82ms,p〈0.05）,and they were decreased in treatment group than control group （Pmax： 108.82±8.27ms vs 126.28±6.24ms,p〈0.05 ;Pd：29.28±5.92ms VS 44.07±6.30ms,p 〈0.05）. The incidence of PAF was decreased after 3 months of treatment compared with control group （12 vs 6）. Conclusions Pmax and Pd increased apparently in hypertensive patients with PAF. Carvedilol can reduce PAF by decreasing Pmax and pd.