螺内酯联合胺碘酮治疗非瓣膜病阵发性心房颤动的临床研究

Clinical study on the therapeutic effect of spirolactone with amiodarone on patients with paroxysmal atrial fibrillation of nonvalvular disease

目的观察螺内酯联合胺碘酮治疗非瓣膜病阵发性心房颤动的效果。方法68例非瓣膜病阵发性心房颤动患者,随机分为合用组(螺内酯加胺碘酮)32例及单用组(单用胺碘酮)36例。两组均常规给予胺碘酮,合用组在此基础上加用螺内酯20mg/d,观察6个月,观察两组的左心房内径、复发率及不良反应。结果合用组的左心房内径较单用组减小[(36.3±6.56)mm比(45.2±7.43)mm],两组比较差异有统计学意义(P<0.05)。合用组复发率28.1%(9/32),单用组复发率52.8%(19/36),两组比较差异有统计学意义(P<0.05)。结论螺内酯联合胺碘酮可抑制左心房结构重构,减少阵发性房颤的复发。

Objective To observe the therapeutic effect of spirolactone with amiodarone on patients with paroxysmal atrial fibrillation of nonvalvular disease. Methods 68 patients with nonvalvular disease complicated with paroxysmal atrial fibrillation were randomly divided into two groups, 32 patients in combined treatment group were treated by spirolactone combined with amiodarone;36 patients in amiodarone group were treated by amiodarone only.The patients in both groups were given amiodarone,while the patients in combined treatment group,on the basis of amiedarone grou p,were given spimlactone 20 mga day,with a treatment course of six months for two groups.The diametre of the left atrium and the rate of recrudescence, adverse reaction in both groups were observed. Results The recrudescence rates were 28.1%（9/32） in combined treatment group and 52.8%（19/36） in arniodarone group,there was a significant difference between two groups （P〈0.05）.The diametre of the left atrium in combined treatment group was significantly shorter than that in amiodarone group[ （36.3±6.56）mm vs （45.2±7.43） mm ]. Conclusion Spirolactone combined with amiodarone can reduce the trecrudesce-nee of paroxysmal atrial fibrillation with nonvalvular disease.