高血压合并心房颤动患者采用不同用药方式的临床疗效

Effects of Different Medication Methods on Patients with Hypertensive complicated with Atrial Fibrillation

目的 探讨不同用药方式治疗高血压合并心房颤动患者的临床疗效。方法 选取2020年4月至2021年4月佛山复星禅诚医院收治的高血压合并心房颤动患者120例作为研究对象,按照治疗方式分为Ⅰ组(n=41)、Ⅱ组(n=39)、Ⅲ组(n=40)。Ⅰ组治疗药物为替米沙坦,Ⅱ组为替米沙坦、阿托伐他汀,Ⅲ组为苯磺酸左氨氯地平片。比较3组患者血压(收缩压、舒张压),心脑血管事件(脑卒中、急性心力衰竭、急性心肌梗死(AMI)、动脉粥样硬化、心源性死亡)发生情况,症状型阵发性心房颤动患者预后情况(临床疗效、复发、转为持续性心房颤动),血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],左房内径(LAD),左室质量指数(LVMI)。结果 治疗后,Ⅱ组脑卒中、急性心力衰竭、AMI、动脉粥样硬化、心源性死亡发生率低于Ⅰ组、Ⅲ组(P<0.05);Ⅰ组、Ⅱ组症状型心房颤动患者治疗有效率高于Ⅲ组,复发率、转为持续性心房颤动率低于Ⅲ组,差异有统计学意义(P<0.05);治疗后,Ⅱ组TG、TC、LDL-C水平低于Ⅰ组、Ⅲ组,HDL-C高于Ⅰ组、Ⅲ组,差异有统计学意义(P<0.05);治疗后,Ⅰ组、Ⅱ组LAD、LVMI水平低于Ⅲ组,且Ⅱ组LAD、LVMI水平低于Ⅰ组,差异有统计学意义(P<0.05)。结论 替米沙坦联合阿托伐他汀可有效降低高血压合并心房颤动患者心脑血管事件发生率、症状型阵发性心房颤动复发率及转为持续性心房颤动概率,同时可减少LAD、LVMI。

Objective To explore the clinical effect of different medication methods in the treatment of hypertension complicated with atrial fibrillation.Methods A total of 120 patients with hypertension combined with atrial fibrillation admitted to Foshan Fosun Chancheng Hospital from April 2020 to April 2021 were selected as the study objects,and were divided into group Ⅰ(n=41),group Ⅱ(n=39) and group Ⅲ(n=40) according to treatment methods.Group Ⅰ was treated with telmisartan,group Ⅱwith telmisartan and atorvastatin,and group Ⅲ with levamlodipine besylate tablets.Blood pressure(systolic and diastolic blood pressure),occurrence of cardiovascular and cerebrovascular events(stroke,acute heart failure,acute myocardial infarction(AMI),atherosclerosis,cardiogenic death),prognosis of symptomatic paroxysmal atrial fibrillation(clinical efficacy,recurrence,conversion to persistent atrial fibrillation),blood lipids [triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],left atrial diameter(LAD),left ventricular mass index(LVMI) in the 3 groups were compared.Results After treatment,the incidence of stroke,acute heart failure,AMI,atherosclerosis and cardiac death in group Ⅱ was lower than that in group Ⅰ and group Ⅲ(P<0.05).The effective rate of symptomatic atrial fibrillation in groups Ⅰ and Ⅱ was higher than that in group Ⅲ,and the recurrence rate and conversion rate to persistent atrial fibrillation were lower than that in group Ⅲ,the difference was statistically significant(P<0.05).After treatment,the levels of TG,TC and LDL-C in group Ⅱwere lower than those in groups Ⅰ and Ⅲ,and HDL-C was higher than those in groups Ⅰ and Ⅲ,the difference was statistically significant(P<0.05).After treatment,the LAD and LVMI levels in groups Ⅰ and Ⅱ were lower than those in group Ⅲ,and the LAD and LVMI levels in group Ⅱ were lower than those in group Ⅰ,the difference was statistically significant(P<0.05).Conclusion Telmisartan combined with atorvastatin can effectively reduce the incidence of cardiovascular and cerebrovascular events,the recurrence rate of symptomatic paroxysmal atrial fibrillation and the probability of conversion to persistent atrial fibrillation in patients with hypertension and atrial fibrillation,and can also reduce LAD and LVMI.