阿托伐他汀钙联合替米沙坦对持续心房颤动电复律后窦性心律维持及炎症反应的影响

Effects of atorvastatin combined with telmisartan on the maintenance of sinus rhythm and inflammatory response in the patients with persistent atrial fibrillation after electrical cardioversion

目的:观察阿托伐他汀钙联合替米沙坦对持续心房颤动电复律后窦性心律维持及炎症反应的影响。方法:将76例持续性心房颤动并拟行电复律的患者随机分为观察组和对照组各38例。复律后对照组口服胺碘酮片0. 2 g,每日1次,观察组在对照组基础上加用阿托伐他汀钙10 mg,每日1次,替米沙坦片40 mg,每日1次。记录2组复律后第1、3、6个月的窦性心律维持率,比较2组复律前及复律后第1、3、6个月超敏C反应蛋白(hs-CRP)水平,随访2组患者治疗期间的不良反应。结果:复律后1个月2组窦性心律维持率差异无统计学意义(P>0. 05),复律后第3、6个月观察组窦性心律维持率高于对照组(P<0.05);观察组复律后第1、3、6个月hs-CRP水平均较复律前下降(P<0.05),且均低于同期对照组(P<0. 05),对照组复律前后hs-CRP水平差异无统计学意义(P>0. 05); 2组不良反应发生率差异无统计学意义(P>0.05)。结论:持续性心房颤动电复律后联合使用阿托伐他汀钙、替米沙坦,能降低机体炎症反应,提高窦性心律维持率。

Objective To observe the effect of atorvastatin combined with telmisartan on the maintenance of sinus rhythm and inflammatory response in the patients with persistent atrial fibrillation after electrical cardioversion.Methods Seventy-six patients with persistent atrial fibrillation who had been ready for electrical cardioversion,were randomly divided into observation group（ n=38） and control group（ n=38） .Patients in the control group were given amiodarone（0.2 g,once every morning） after electrical cardioversion,while the observation group were given amiodarone（0.2 g,once every morning）,atorvastatin（ 10 mg,once every morning）,telmisartan（40 mg,once every morning）.The maintenance of sinus rhythm in the two groups after electrical cardioversion in the first,third,and sixth month respectively was observed.The level of high-sensitivity C-reactive protein（hs-CRP） of the two groups before and after electrical cardioversion,and the adverse reactions during the treatment was analyzed.Results There was no significant difference between the two groups in the maintenance of sinus rhythm in the first month after electrical cardioversion（ P〉0.05）.The maintenance rate of sinus rhythm of the observation group in the third and sixth month after electrical cardioversion was higher than that of the control group（ P〈0.05）.The level of hs-CRP of the observation group in the first,third,and sixth month after electrical cardioversion was lower than before（ P〈0.05）,and also lower than the control group（ P〈0.05）,while there was no significant difference in the control group before and after electrical cardioversion（ P〉0.05）.There was no significant difference between the two groups in the rate of the adverse reactions（ P〉0.05）.Conclusion Using atorvastatin combined with telmisartan for the patients with persistent atrial fibrillation after electrical cardioversion can reduce the inflammatory response and improve the sinus rhythm maintenance rate.