缬沙坦对老年高血压合并持续性心房颤动患者炎症因子及左心房内径的影响

The Effects of Valsartan on Levels of Inflammatory Factors and Left Atrial Diameter in the Elderly Patients with Hypertension Complicated Persistent Atrial Fibrillation

目的探讨缬沙坦对老年高血压合并持续性心房颤动患者炎症因子表达水平及左心房内径的影响。方法将125例高血压病持续性心房颤动的老年患者随机分成缬沙坦组(65例)和对照组(60例),在常规抗心律失常、抗凝药物治疗基础上,缬沙坦组给予缬沙坦降压治疗,对照组予以硝苯地平降压治疗。6个月后比较两组患者治疗前后血清炎症因子(CRP、TNF_α、IL_6和AngⅡ)水平及左心房内径(LAD)变化。结果两组患者基础临床资料差异无统计学意义(P>0.05)。6个月后,与同组治疗前及对照组治疗后比较,缬沙坦组患者血清CRP、TNF_α、IL_6和AngⅡ水平明显下降、LAD显著缩小,差异均有统计学意义(均P<0.05)。结论缬沙坦可降低老年高血压患者合并持续性心房颤动时的炎症反应,改善心房重构,以减少心房颤动的发生和维持。

Objective To investigate the effects of valsartan on levels of inflammatory factors and left atrial diameter（ LAD）in the elderly patients with hypertension complicated persistent atrial fibrillation. Methods 125 elderly patients with hypertension complicated with persistent atrial fibrillation were randomly divided into valsartan group（ 65 cases） and control group（ 60cases）. On top of conventional anti-arrhythmic and anti-coagulant therapy,valsartan and nifedipine controlled releases tablets were used for antihypertensive therapy in valsartan group and control group respectively. After 6 months＇ treatment,the levels of inflammatory factors,including C-reactive protein（ CRP）,Interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）,angiotensin（ AngⅡ）,and the LAD variation of left atrium for both groups were compared. Results Before treatment,there was no significant difference between two groups（ P〉0. 05）. Compared with that before treatment and control group after treatment,the serum levels of CRP,IL-6,TNF-α and AngⅡ in valsartan group were significantly decreased and LAD was obviously decreased after 6 months（ all P〈0. 05）. Conclusions There is an independent anti-inflammatory effect of valsartan on elderly patients with hypertension complicated persistent atrial fibrillation,decreasing inflammatory reaction can improve atrial remodeling and reduce the occurrence and maintenance of AF.