替米沙坦联合胺碘酮治疗高血压伴阵发性心房颤动患者疗效及对血清BNP、MMP-2及CTGF水平的影响

Efficacy of Telmisartan Combined with Amiodarone in the Patients with Hypertension Complicated with Paroxysmal Atrial Fibrillation and Influence on the Levels of Serum BNP,MMP-2 and CTGF

目的:探讨替米沙坦联合胺碘酮对高血压伴阵发性心房颤动患者血清脑钠肽(BNP)、基质金属蛋白酶-2(MMP-2)及结缔组织生长因子(CTGF)水平的影响。方法:90例高血压伴阵发性心房颤动患者随机分为胺碘酮+替米沙坦组和胺碘酮组,每组45例。胺碘酮组给予胺碘酮片维持治疗,胺碘酮+替米沙坦组给予替米沙坦联合胺碘酮治疗。治疗12个月后比较两组临床疗效及患者血压、心率、左心房容积、房颤次数及持续时间的变化,分析两组患者治疗前后血清BNP、MMP-2及CTGF水平变化。结果:胺碘酮+替米沙坦组治疗总有效率为95.6%,显著高于胺碘酮组的75.6%(P<0.05)。治疗后胺碘酮+替米沙坦组患者血压水平、左心房舒张末和收缩末容积心房颤动次数及维持时间均较前明显改善(P<0.05),且均明显优于胺碘酮组(P<0.05)。治疗后两组患者血清MMP-2、CTGF水平均较前明显降低(P<0.05),胺碘酮+替米沙坦组BNP、MMP-2及CTGF水平均明显低于胺碘酮组(P<0.05)。结论:替米沙坦联合胺碘酮治疗高血压伴阵发性心房颤动的疗效确切,能够抑制患者左心房扩大,减少心房颤动次数及持续时间,降低患者血清BNP、MMP-2及CTGF水平。

Objective： To explore the effect of telmisartan combined with amiodarone on the levels of serum brain natriuretic pep- tide （BNP）, matrix metalloproteinase-2 （MMP-2） and connective tissue growth factor （CTGF） in the patients with hypertension com- plicated with paroxysmal atrial fibrillation. Methods： A total of 90 hypertensive patients with paroxysmal atrial fibrillation were ran- domly divided into amiodarone ＋ telmisartan group and amiodarone group. The 45 patients in amiodarone group were treated with amio- darone hydrochloride and the 45 patients in amiodarone ＋ telmisartan group were treated with telmisartan combined with amiodarone. After 12-month treatment, the clinical effect, changes of blood pressure, heart rate, left atrial volume, recurrence frequency and dura- tion time of atrial fibrillation were compared between the groups, and the levels of serum BNP, MMP-2 and CTGF before and after the treatment were detected. Results： The total effective rate of amiodarone ＋ telmisartan group was 95.6% , which was significantly higher than that of amiodarone group （75.6%, P 〈 0.05 ）. The blood pressure, recurrence frequency and duration time of atrial fibrillation were significantly improved after the treatment in the two groups （ P 〈 0.05 ）. The blood pressure, left atrial volume and situation of at- rial fibrillation in amiodarone ＋ telmisartan group were better than those in amiodarone group after the treatment （ P 〈 0.05 ）. The levels of serum MMP-2 and CTGF were significantly reduced in the two groups after the treatment, and the levels of BNP, MMP-2 and CTGF in amiodarone ＋ telmisartan group were significantly lower than those in amiodarone group （ P 〈 0.05 ）. The incidence of adverse reac- tion was not significantly different in the two groups （ P 〉 0.05 ）. Conclusion： Telmisartan combined with amiodarone in the treatment of hypertension complicated with paroxysmal atrial fibrillation shows promising curative effect, which can inhibit the left atrial expan- sion, decrease the frequency and duration time of atrial fibrillation and reduce the levels of serum BNP, MMP-2 and CTGF.