厄贝沙坦联合胺碘酮治疗老年阵发性心房颤动的临床观察

Clinical efficacy of irbesartan and amiodarone in elderly patients with paroxysmal atrial fibrillation

目的:评价厄贝沙坦与胺碘酮联合治疗老年阵发性心房颤动(简称房颤)的疗效。方法:将91例年龄≥60岁的阵发性房颤患者随机分为胺碘酮组(Ⅰ组,n=45)和胺碘酮+厄贝沙坦组(Ⅱ组,n=46),治疗后随访18个月。比较两组治疗后3,6,9,12,18个月的窦性心律维持率和治疗前、治疗后6,12,18个月的左房前后径。结果:治疗后3个月,Ⅰ组窦性心律维持率为88.4%,与Ⅱ组(90.9%)比较无统计学差异(P>0.05)。治疗后6,9,12,18个月,Ⅰ组窦性维持率分别为72.1%,65.1%,60.5%,55.8%,Ⅱ组分别为88.6%,86.4%,81.8%,79.5%,两组均有统计学差异(P<0.05)。而治疗12个月后,Ⅰ组左心房前后径明显大于Ⅱ组(P<0.05)。结论:厄贝沙坦与胺碘酮联合治疗老年阵发性心房颤动维持窦性心律的疗效优于单用胺碘酮,且能抑制左房扩大。

Objective To investigate the effect of combination of irbesartan and amiodarone in elderly patients with paroxysmal atrial fibrillation. Methods Ninety-one patients with paroxysmal atrial fibrillation were randomly divided into 2 groups ： Group Ⅰ （ amiodarone group, n = 45 ） and Group Ⅱ （amiodarone plus Irbesartan group, n = 46 ）. After 18 month follow-up, the maintenance rate of sinus rhythm was measured in the 3 rd, 6th, 9th, 12th, and 18th months, and the left atrial diameter （ LAD ） was measured before the treatment and 6th, 12th, and 18 th months after the treatment. Results There was no difference in the maintenance rate of sinus rhythm between Group Ⅰ and Group Ⅱ in the 3rd month. The maintenance rate of sinus rhythm in Group Ⅰ was 72. 1% , 65.1%, 60.5%, and 55. 8% in the 6th, 9th, 12th, and 18th months, and the rate in the Group Ⅱ was 88.6%, 86.4%, 81.8%, and 79.5%. They both had significant difference （P〈 0.05 ）. At 12 months after the treatment, LAD in Group Ⅰ was significantly larger than that of Group Ⅱ （ P 〈 0.05 ）. Conclusion The combination of irbesartan and amiodarone is more effective than amiodarone alone for sinus rhythm maintenance, andmay restrain the enlargement of the left atrium.