厄贝沙坦预防房颤复律后复发及治疗前后患者左房径变化的临床观察

The Curative Effect of Irbesartan Used with low Dose of Amiodaron on the Recurrence After Defibrillation and the Analysis of the Change of Left Atrial Diameter

目的:研究厄贝沙坦预防房颤复律后复发的效果及治疗前后左房径的变化。方法:选取2004年5月至2005年12月我院住院治疗的应用胺碘酮转复为窦性心律的房颤患者100例,随机分为具有可比性的试验组(n=60)和对照组(n=40),两组患者在常规抗凝的基础上均给予口服胺碘酮治疗,逐渐减为维持量,0.2g/次,1次/d。试验组同时加用厄贝沙坦75-150mg/次,1次/d。对照组不给予血管紧张素转换酶抑制剂(ACE-I)类及血管紧张素受体拮抗剂(ARB)。观测终点为房颤复发或满12个月。结果:试验组房颤复发率低于对照组(23.33%比47.5%,p<0.05);治疗前后左房径无显著差异。结论:厄贝沙坦对房颤复律后复发有预防作用,尤其对心房电重构起到主导作用。

Objective： To explore the effects of erbesartan used with low dose of amiodaron on the Recurrence after defibrillation and To analysis the change of left atrial diameter. Method： We recruited 100 patients with fibrillation in our hospital from May 2004 to Jun 2005. After defibrillation by amiodaron, these patients were randomly divided into comparable intervention group （ n = 60 ） and control group （ n = 40 ）. Then patients in two groups were treated by 0.2g qd of amiodaron and anticoagulant. 75 - 150 mg/day of Irbesartan was used in intervention patients, but not in control group. Not any ACE - I or ARB were used in control group. Research endpoint was recurrence of fibrillation or not in 12 months. Result： Recurrence rate were 23.33% and 47.50% （ p 〈0.05 ） for intervention and control groups,respectively. There was no significant difference with left atrial diameter between the two groups. Conclusion： There was preventive effects of Irbesartan used on the recrudescent after defibrillation. Atrial electrical remodeling has leading function in the recurrence.