厄贝沙坦联合胺碘酮对慢性心力衰竭患者P波离散度与阵发性心房颤动的影响

Joint Effect of Irbesartan and Amiodarone on P Wave Dispersion and Paroxysmal Atrial Fibrillation in Patients with CHF

目的探讨厄贝沙坦联合胺碘酮对慢性心力衰竭(congestive hearts failure,CHF)的P波离散度与阵发性心房颤动的影响。方法选取90例CHF患者,采取随机数字表法分为对照组与观察组,每组各45例,两组均给予CHF基础用药,对照组在其基础上加用厄贝沙坦,观察组在对照组基础上加用胺碘酮治疗,疗程6个月,比较两组治疗前后P波离散度及阵发性心房颤动发生情况。结果两组治疗后与治疗前比较P波最大值及P波离散度降低,而观察组治疗后与对照组治疗后比较上述指标改善更加显著,差异具有统计学意义(P<0.05)。两组治疗后与治疗前比较左心室舒张期内径(LVDd)降低,左心室射血分数(LVEF)升高,而观察组更加显著,差异均具有统计学意义(P<0.05)。两组治疗后与治疗前比较心房颤动发作次数及心房颤动发生率降低,而观察组更加显著,差异均具有统计学意义(P<0.05)。结论厄贝沙坦联合胺碘酮治疗CHF能够降低P波离散度,逆转左心室重构,降低阵发性心房颤动的发生频率。

Objective To explore joint effect of irbesartan and amiodarone on P wave dispersion and paroxysmal atrial fibrillation in patients with chronicheart failure （CHF）. Methods 90 patients with CHF of our hospital in May 2014 were selected and randomly di- vided into control group and observation group, with 45 cases in each group. Both groups were given basic treatment of CHF at first. Then the control group was treated with irbesartan while the observation group was treated with amiodarone. After 6 months of thera- py, the change of P wave dispersion and paroxysmal atrial fibrillation were compared between the two groups. Results Compared with before treatment, P wave maximum and P wave dispersion decreased in both groups after treatment, but the above indexes improved more significantly in the observation group than those in the control group （ P 〈 0.05）. After the treatment, LVDd was reduced while LVEF was increased in two groups. These improvements were more significantly in the observation group （P 〈 0.05）. The incidence of atrial fibrillation was decreased in the two groups after the treatment, but the observation group improved more significantly than the other group （ P 〈 0.05）. Conclusions Combined with amiodarone, irbesartan is able to reduce p wave dispersion and the frequency of atrial fibrillation as well as reverse left ventrieular hypertrophy in die treatment of CHF.