坎地沙坦治疗老年高血压病合并阵发性房颤的临床观察

Clinical observation on candesartan in the treatment of senile hypertension complicated with paroxysmal atrial fibrillation

目的探讨坎地沙坦治疗老年高血压病合并阵发性房颤患者的临床疗效及对复发情况及左房内径的影响。方法选择老年高血压病合并阵发性房颤84例,随机分为治疗组(n=42)和对照组(n=42),治疗组给予坎地沙坦治疗,对照组给予拉西地平治疗,两组均视血压情况酌情加用利尿剂,随访18个月,比较两组对老年高血压控制情况、房颤的复发次数、复发持续时间及左心房内径的影响。结果治疗后两组血压均较治疗前明显降低;两组治疗后降压疗效差异无统计学意义(P>0.05),治疗组心房颤动复发次数明显低于对照组[(5.36±1.04)次vs(9.54±1.24)次,P<0.01)];治疗组发作持续时间短于对照组[(15.3±4.9)hvs(23.3±5.9)h,P<0.01];治疗组左房内径比治疗前明显缩小,对照组无明显变化,两组比较差异有统计学意义(P<0.01)。结论坎地沙坦治疗老年高血压病合并房颤患者能有效降低血压,并减少房颤复发和房颤的持续时间,同时能明显抑制左房重构。

Objective To observe the clinical effect ofcandesartan on patients with senile hypertension complicated with paroxysmal atrial fibrillation, and to investigate its effect on recurrence situation and left atrial diameter alteration. Methods Eight-four patients with senile hypertension complicated with paroxysmal atrial fibrillation were randomized into the study group （n=42, treated with candesartan） and the control group （n=42, treated with lacidipine）. Diuretics was added according to the blood pressure of patients. All the patients were followed up for 18 months. The blood control situation, atrial fibrillation recurrence frequency and duration time, alteration of left atrial inner diameter Were compared between the two groups. Results The level of blood pressure in both groups after treatment was significantly decreased than baseline, and there was no statistically significant difference in the decrease of blood pressure after treatment between the two groups （P〉0.05）. The atrial fibrillation recurrence frequency in the stud group was （5.364.1.04） time, which was significantly lower than that in the control group [（9.54± 1.24） time, P〈 0.01. The paroxysmal atrial fibrillation duration time in the stud group was （15.3±4.9） h, which was significantly lower than that in the control group [（23.3±5.9） hi, P〈0.05. After treatment, the left atrial inner diameter in the study group was significantly diminished compared with that before treatment, while the left atrial inner diameter in the control group showed no statistically significant difference with that before treatment. Conclusion For patients with senile hypertension complicated with paroxysmal atrial fibrillation, Candesartan is effective to control blood pressure, decrease atrial fibrillation recurrence frequency and duration, and inhibit left atrioventricular remodeling.