西拉普利联合坎地沙坦防治心力衰竭合并心房颤动59例

Cilazapril combined with candesartan on chronic heart failure with atrial fibrillation in 59 cases

目的探讨血管紧张素转换酶抑制剂（西拉普利）联合血管紧张素Ⅱ受体拮抗剂（坎地沙坦）对慢性心力衰竭（CHF）合并心房颤动（AF）的疗效。方法慢性心力衰竭合并阵发性房颤患者121例随机分为常规治疗（对照组）62例和治疗组59例，治疗组除常规治疗并加用西拉普利（1．25～5mg／d）基础上，再给予坎地沙坦（2～8mg／d）口服，治疗前及治疗后4周分别行常规超声心动图检查，临床评价心功能。结果治疗组治疗后房颤复发率为10．17％，明显低于对照组的22．58％，两组比较差并有统计学意义，P〈0.05；治疗组心功能分级（NYHA）及左室射血分数（LVEF）等较对照组叫显改善。结论血管紧张素Ⅱ受体拮抗剂联合血管紧张素转换酶抑制剂能明显改善慢性心力衰竭合并阵发性房颤患者的心功能，减少房颤的复发率。

Objective To investigate the effects of ACEI （cilazapril） combined with ARB （candesartan） on chronic heart failure （CHF） patients with paroxysmal atrial fibrillation （AF）. Methods One hundred and twenty -one CHF with paroxysmal AF patients were divided into the cilazapril combination with candesartan treatment group （59 cases） and the eontrol group （62 cases） randomly. The general therapy included digoxin, diuretics,angiotensin converting enzyme inhibitors （ACEI） cilazapril （ 1.25 - 5 mg/d） and anticoagulants. Besides this therapy, angiotensin receptor blockers （ARBs） candesartan （2 -8 mg/d） was added to treament group. The short term effects in 4 weeks were compared in two groups. Results The NYHA heart function classes and left ventrieular ejection fraction （LVEF） increased obviously（ P 〈0.05 and P 〈0.01 ） ,with AF recurrence obvious decreased （ P 〈0.05） in two groups 4 weeks after admission. Conclusion Based on the medication of digoxin, diuretics, ACEI and anticoagulants, added ARB therapy can improve the short- term effects on CHF with paroxysmal AF patients and decrcase AF recurrence.