左旋氨氯地平治疗高血压合并阵发性心房颤动的临床效果研究

Clinical effect of L-amlodipine on atrial fibrillation complicated with hypertension

目的：研究左旋氨氯地平治疗高血压合并心房颤动的临床效果。方法入选2005年7月-2013年7月在我院心内科诊疗的610例高血压合并阵发性心房颤动患者，随机分为治疗组与对照组，每组305例，其中治疗组予以左旋氨氯地平，2.5-10.0 mg/ d；对照组予以缬沙坦片，80-160 mg/ d。治疗1年后，检测分析两组的收缩压（SBP）、舒张压（DBP）、Pd、左房横径（LAD）、超敏 C 反应蛋白（hs-CRP）及脑钠肽（BNP）水平以及房颤复发率。结果治疗1年后随访发现，两组的 SBP、DBP、Pd、LAD、hs-CRP 及 BNP 水平均较治疗前显著下降（P ﹤0.05），而两组的 SBP、DBP、Pd、LAD、hs-CRP 及 BNP 水平之间均无统计学差异（P ﹥0.05）；缬沙坦组房颤复发率为28.85％（88/305），左旋氨氯地平组为31.15％（95/305），两组间房颤复发率相比较无统计学差异（P ﹥0.05）。结论对于高血压合并阵发性心房颤动患者，左旋氨氯地平可以很好地降压和防治房颤，降低 LAD、hs-CRP 和 BNP 水平，其效果与缬沙坦类似。

Objective To explore the clinical effect of L-amlodipine on atrial fibrillation complicated with hypertension. Methods 610 cases with atrial fibrillation complicated with hypertension hospitalized in the period from July,2005 to July,2013 were randomly divided into 2 groups：treatment group and control group,305 cases in each;L-amlodipine 2. 5 to 10. 0 mg daily was administrated to cases in treatment group,while valsartan 80 to 160 mg daily to cases in control group;the course lasted for 1 year;the levels of SBP,DBP,Pd,LAD,hs-CRP,BNP and reoccurrence of atrial fibrillation in both groups were observed after the treatment. Results The levels of SBP,DBP,Pd,LAD,hs-CRP and BNP in both groups decreased obviously after treatment compared with those before treatment（ P ﹤ 0. 05）,while there existed no difference of statistical significance between the 2 groups（ P ﹥ 0. 05）;the reoccurrence of atrial fibrillation was 28. 85%（88 / 305）in control group and 31. 15%（95 / 305）in treatment group,the difference in reoccurrence of atrial fibrillation between the 2 groups was of no statistical significance（P ﹥ 0. 05）. Conclusions L-amlodipine is effective in decreasing blood pressure and preventing reoccurrence of atrial fibrillation in patients with atrial fibrillation complicated with hypertension,and it can decrease the levels of LAD,hs-CRP and BNP;it has the similar effect to valsartan.