氯沙坦联合胺碘酮治疗心房纤颤的临床疗效观察

Effect of losartan combined with amiodarone on atrial fibrillation

目的心房纤颤是临床常见的心律失常,药物治疗是其治疗的重要部分。文中观察氯沙坦(Losartan)联合胺碘酮(Amiodarone)治疗心房纤颤(简称房颤)的临床效果,并探讨其机制与安全性。方法将43例房颤患者随机分为观察组27例、对照组16例,观察组给予胺碘酮和氯沙坦,对照组则单用胺碘酮,治疗共6个月。结果经过治疗,观察组治疗结束后随访6月窦性心律维持明显高于对照组,左心房内径明显低于对照组,左心房射血分数明显高于对照组,有显著性差异(P<0.05)。2组患者不良反应发生情况类似,患者均可耐受。结论氯沙坦联合胺碘酮治疗房颤,疗效显著,作用持久,无严重不良反应发生,可以有效安全地应用于临床,疗效优于单独使用胺碘酮。

Objective Atrial fibrillation is a common arrhythmia in clinic,which is mainly treated by drugs.The present study was to observe the effect of Amiodarone combined with Angiotensin ⅡReceptor Blocker（ARB）-Losartan on atrial fibrillation（AF）.Methods Forty-three consecutive patients with persistent atrial fibrillation were randomly divided into two groups： Amiodarone-treated group（Group A,16 patients）,and Amiodarone-Losartan-treated group（Group B,27 patients）.After one month′s oral medication,patients′ left atrial diameter（LAD）,left atrial ejection fraction（LAEF） as well as general condition were determined during their six months′ follow-up.Results Among the 43 patients completed the clinical observation,LAD was significantly larger in Group A than that in Group B（P0.05）,while the LAEF in Group A was significantly lower than that in Group B.Obviously the ratio of successful sinus rhythm maintenance in Group B was higher than that in Group A（P0.05）.Conclusion The prescription of Amiodarone plus Losartan could reverse left atrium expansion,reverse atrial fibrillation,and maintain sinus rhythm more effectively than single oral Amiodarone.