胺碘酮与厄贝沙坦联合治疗阵发性心房颤动的前瞻随机对照研究

Study on amiodarone plus irbesartan in treatment of paroxysmal auricular fibrillation

目的:评价胺碘酮和厄贝沙坦联合治疗阵发性心房颤动维持窦性心律的长期疗效。方法:将110例阵发性房颤患者随机分为胺碘酮组(Ⅰ组,n=55)、胺碘酮+厄贝沙坦组(Ⅱ组,n=55),治疗随访时间为2年,研究的一级终点为房颤复发。比较两组治疗后的窦性心律维持率以及治疗前、治疗后6、12、18和24个月的左心房内径。结果:治疗12个月后,I组左心房内径大于Ⅱ组(P<0.05)。试验终点时,I组的窦性心律维持率为58.18%(32/55),Ⅱ组为78.18%(43/55)。持续性窦性心动过缓和QT间期≥0.5s的发生率两组间差异无统计学意义。结论:胺碘酮联合厄贝沙坦,治疗阵发性房颤维持窦性心律优于单用胺碘酮,并能抑制左心房的扩大。

Objective： To evaluate the clinical efficacy of irbesartan plus amiodarone on maintenance of sinus rhythm in patients with paroxysmal auricular fibrillation （PAF）. Methods： 110 patients with PAF were randomly divided into two groups： group I （n=55） was treated with amiodarone alone; group II （n=55） was treated with amiodarone plus irbesartan. The left atrial diameter （LAD）was measured with transthoracic echocardiogram 6, 12, 18 and 24 months before and after treatment. The follow-up study was two years and the primary end point of the study was the first recurrence of auricular fibrillation （AF）. Results： After 12 months of treatment, LAD in group I was significantly larger than that in group II （P〈0.05）. At the end of the study, the sinus rhythm maintenance of group I was lower significantly than that of group Ⅱ. （58.18% vs 78.18%, P〈0.05）. Conclusions： Amiodarone plus irbesartan, in maintenance of sinus rhythm, for patients with paroxysmal auricular fibrillation is superio to amiodarone alone.They can inhibit the enlargement of left atrium and reduce recurrence rate in patients with PAF.