厄贝沙坦联合胺碘酮对心脏瓣膜病合并阵发性心房颤动患者窦性心律的维持及心室重构的影响

The influence of irbesartan combined with amiodarone to sinus rhythm maintenance and ventricular remodeling in patients with valvular heart disease combined paroxysmal atrial fibrillation

目的探讨厄贝沙坦联合胺碘酮对心脏瓣膜病合并阵发性心房颤动(AF)患者窦性心律的维持及心室重构的影响。方法将96例心脏瓣膜病合并阵发性AF患者随机分为观察组与对照组,每组各48例,两组患者均给予介入心脏瓣膜手术及射频消融术治疗,术后观察组患者给予胺碘酮联合厄贝沙坦治疗,对照组患者仅给予胺碘酮治疗,对比两组患者术后窦性心律维持及心室重构情况。结果术后1个月时两组患者窦性心律维持率比较差异无显著性(P>0.05),术后6个月观察组患者窦性心律维持率显著高于对照组(P<0.05)。两组患者术前左室舒张末期内经(LVEDd)及左室射血分数(LVEF)比较差异无显著性(P>0.05),术后6个月两组患者LVEDd及LVEF较术前均显著增加(P<0.01),且观察组显著高于对照组(P<0.01)。结论厄贝沙坦联合胺碘酮用于心脏瓣膜病合并阵发性AF患者的术后治疗,能够在有效维持术后窦性心律的基础上,最大限度地延缓或逆转心室重构。

Objective To discuss the influence to sinus rhythm maintenance and ventricular remodeling of irbesartan combined with amiodarone in patients with valvular heart disease and paroxysmal atrial fibrillation （AF）. Method 96 patients with valvular heart disease and paroxysmal AF were randomly divided into observation group and control group, 48 cases in each group, all the patients were treated with interventional procedures ＋ radiofrequency ablation, observation group were treated with Irbesartan combined with amiodarone, control group were treated with amiodarone only after surgery, then the maintenance of sinus rhythm and ventricular remodeling were compared between the two groups. Result There was no significantly difference in maintenance rate of sinus rhythm between the two groups 1 month postopertaion （P 〉 0.05）, observation group was significantly higher than control group 6 months postopertaion （P 〈 0.05）; there was no significantly difference in LVEDd and LVEF preoperation （P 〉 0.05）, but significantly improved 6 months postopertaion （P 〈 0.01）, and observation group significantly higher than control group （P 〈 0.01）. Conclusion Irbesartan combined with amiodarone can delay or reverse ventricular remodeling at utmostextremely on the basis of maintaining sinus rhythm in post-operative patients with valvular heart disease combined AF.