替米沙坦联合胺碘酮对急性心肌梗死并心房颤动患者的治疗作用

Effects of telmisartan combined with amiodarone on acute myocardial infarction complicated with atrial fibrillation

目的观察替米沙坦联合胺碘酮对急性心肌梗死（acute myocardial infarction,AMI）合并心房颤动（atrial fibrillation,AF）患者转复率及维持窦性心律的疗效,及对这类患者住院时间及院内病死率的影响。方法 AMI合并AF患者164例,随机分为治疗组和观察组,所有患者均予胺碘酮治疗,治疗组82例加用替米沙坦40-80 mg/d治疗,观察第24 h、3 d、5 d和7 d时AF的转复情况,并统计住院天数及院内病死率。治疗并随访2年,比较两组的窦性心律维持率。结果治疗后第5天及第7天,治疗组AF转复率高于观察组,且差异均有统计学意义（P〈0.05）;治疗后第12、18、24个月,治疗组的窦性心律维持率显著高于观察组,差异均有统计学意义（P〈0.05）;治疗组住院天数及院内病死率均低于观察组,但差异无统计学意义（P〉0.05）。结论替米沙坦联合胺碘酮对AMI合并AF患者转复率及维持窦性心律具有较好的临床疗效。

Objective To observe the clinical efficacy of telmisartan combined with amiodarone on acute myocardial infarction（AMI） complicated with atrial fibrillation（AF）.Methods164 cases of patients with AMI combined with AF were rando mly divided into treatment group and control group.All patients were treated with amiodarone.The treatment group took telmisartan（40-80 mg/d） additionally.We observed the phenomena of undergoing sinus rhuthm（SR） by the treatment after 24 h,3 d,5 d and 7 d.Re-treatment and follow-up of 2 years,compared SR maintenance rates among these 2 groups before and after this treatment.ResultsThe rate of undergoing SR after 5d and 7d in treatment group was higher than that of control group（P〈0.05）.After treatment of 12,18 and 24 months,the SR maintenance rates of treatment group was higher than that of control group（P〈0.05）.The hospitalizating days and hospital mortality of treatment group were lower than that of the control group,but the difference was not statistically significant（P〉0.05）.ConclusionThe treatment of AMI complicated with AF by telmisartan combined with amiodarone could raise the rate of SR of Af,shorten the recovery time of transfer,and may maintain SR effectively.