厄贝沙坦联合胺碘酮对原发性高血压合并持续性房颤心律转复及脑钠素的影响

Efficacy of irbesartan and amiodarone in the rebuilding of sinus rhythm in patients with persistent atrial fibrillation and primary hypertension and its effect on brain natriuretic peptide

目的 观察厄贝沙坦联合胺碘酮对原发性高血压合并持续性房颤心律转复的影响.方法 选择高血压合并房颤患者98例,随机分为两组,A组（n=50）给予钙拮抗剂和胺碘酮治疗,B组（n=48）给予厄贝沙坦和胺碘酮治疗,随访1年,观察两组左心房内径（LAD）、左室射血分数（LVEF）、脑钠素（BNP）变化及房颤转复率和窦性心律维持率.结果 B组LAD变小,LVEF升高,房颤转复率和窦性心率维持率明显优于A组（P均〈0.05）.两组BNP水平均有下降,B组优于A组（P〈0.05）.结论 厄贝沙坦联合胺碘酮治疗原发性高血压合并持续性房颤在改善心脏功能、提高房颤的转复率和窦性心律维持率方面优于钙拮抗剂联合胺碘酮.

Objective To evaluate the efficacy of irbesartan combined with amiodarone in the rebuilding of sinus rhythm in patients with persistent atrial fibrillation and primary hypertension and its effect on brain natriuretic peptide. Methods Totally 98 patients with persistent atrial fibrillation and primary hypertension were randomly divided into group A （n =50） and group B （n =48）. In group A, patients were given calcium channel blockers and amiodarone, while patients in group B were given irbesartan and amiodarone. All the patients were followed up for 12 months. The rate of successful sinus rhythm rebuilding and its maintenance were counted. The diameter of left atrium （ LAD）, left ventricular ejection fraction （LVEF） and the level of serum brain natriuretic peptide were also measured. Results The LAD decreased and LVEF increased in group B. The rates of successful sinus rhythm rebuilding and its maintenance were higher in group B than those in group A （ P 〈 O. 05 ）. Although the concentration of serum brain natriuretic peptide in both groups were all decreased, the change in group B was more significant than that in group A（P 〈 0. 05 ）. Conclusion For these patients, irbesartan and amiodarone are more effective in sinus rhythm rebuilding and its maintenance than calcium channel blockers and amiodarone, and then improve the cardiac function.