不同剂量胺碘酮联合氯沙坦治疗阵发性房颤患者复律后的窦性心律维持效果

Effect of Different Doses of Amiodarone Combined with Losartan in Treatment of Sinus Rhythm Maintenance of Patients with Paroxysmal Atrial Fibrillation after Cardioversion

目的:研究不同剂量胺碘酮联合氯沙坦治疗阵发性房颤患者复律后的窦性心律维持效果。方法:选取2013年1月到2014年1月我院收治的阵发性房颤患者130例,按照随机数字表法将患者分为A组和B组,每组65例,两组均给予氯沙坦治疗,A组给予胺碘酮600 mg/d,1-2周后改用200 mg/d维持1年;B组给予胺碘酮600 mg/d,1-2周后改用200 mg/d,1个月后改为100mg/d维持1年,比较两组治疗前后转复维持有效率、心率、血压、左房内径(LAD)、左房舒张末期容积(LAEDV)、左房收缩末期容积(LAESV)、左心房射血分数(LAEF)以及不良反应。结果:两组转复维持有效率比较差异无统计学意义(P>0.05);治疗后收缩压、舒张压、LAEDV和LAESV均优于治疗前(P<0.05),但治疗后两组组间心率、收缩压、舒张压、LAD、LAEDV、LAESV、LAEF比较差异无统计学意义(P>0.05);B组不良反应发生率显著低于A组,两组比较差异具有统计学意义(P>0.05)。结论:小剂量胺碘酮联合氯沙坦与大剂量胺碘酮联合氯沙坦治疗阵发性房颤转复效果相当,但是不良反应较少。

Objective： To study the effect of doses of amiodarone combined with losartan in treatment of sinus rhythm maintenance of patients with paroxysmal atrial fibrillation after cardioversion. Methods： 130 cases of patients with paroxysmal atrial fibrillation were selected from our hospital from January 2013 to January 2014, who were divided into group A and group B according to the random number table method, with 65 patients in each group. Two groups were treated with losartan,then group A was treated with amiodarone600 mg/d, after 1-2 weeks the dose was switched to 200 mg/d for 1 year; group B was treated with amiodarone 600 mg/d, after 1-2 weeks the dose was switched to 200mg/d,after 1 month the dose was switched to 100 mg/d for 1 year. Then we compared the cardioversion efficiency,heart rate,blood pressure,left atrial diameter（LAD）, left atrial end diastolic volume（LAEDV）, left atrial end systolic volume（LAESV）,left atrial ejection fraction（LAEF）, and adverse reactions of two groups before and after treatment. Results： Cardioversion efficiency of two groups had no significant difference（P〉0.05）; Systolic blood pressure, diastolic blood pressure, LAEDV and LAESV in two groups after treatment were better than before treatment, the differences were statistically significant（P〈0.05）, but the heart rate, systolic blood pressure,diastolic blood pressure, LAD, LAEDV, LAESV, LAEF in two groups after treatment had no significant difference（P〉0.05）; Incidence of adverse reactions in group B was significantly lower than group A, the difference was statistically significant（P〉0.05）.Conclusion： Low doses of amiodarone combined with losartan has nearly the same effect with high doses on the cardioversion treatment of patients with paroxysmal atrial fibrillation,but the low dose can reduce the adverse reactions.