贝那普利联合阿托伐他汀治疗高血压合并阵发性心房颤动患者疗效观察

Efficacy of benazepril combined with atorvastatin in treatment of patients with hypertension complicated with paroxysmal atrial fibrillation

目的观察贝那普利联合阿托伐他汀治疗高血压合并阵发性心房颤动的疗效,并探究对患者心功能、血清红细胞分布宽度(RDW)、氨基末端B型脑钠肽前体(NT-proBNP)、乳酸脱氢酶(LDH)及血管紧张素-II(Ang-II)水平的影响。方法选取2018年1月至2020年1月就诊于南阳市第二人民医院的150例高血压合并阵发性心房颤动患者,根据随机数字表法分为对照组和观察组各75例。对照组患者予以贝那普利治疗,观察组患者予以贝那普利联合阿托伐他汀治疗,两组均治疗3个月。对比两组患者治疗3个月后疗效以及治疗前、治疗3个月后心功能[左心房内径(LAD)、P波最大时限(Pmax)、P波离散度(Pd)]、血清RDW、NT-proBNP、LDH及Ang-II水平和血清血管假性血友病因子(vWF)、一氧化氮(NO)及内皮素-1(ET-1)水平差异,并随访一年,观察记录两组患者房颤复发率。结果治疗3个月,观察组患者疗效(93.33%)显著高于对照组(82.67%),LAD、Pmax、Pd、RDW、NT-proBNP、LDH、Ang-II、vWF、ET-1水平[(3.42±0.53)cm、(95.26±14.15)ms、(30.75±5.85)ms、(13.24±1.53)%、(525.26±116.85)pg/mL、(153.26±25.74)mmol/L、(59.28±11.36)pg/mL、(132.28±13.05)%、(85.71±10.36)ng/L]显著低于对照组[(3.92±0.60)cm、(105.35±15.53)ms、(34.33±6.74)ms、(13.88±1.36)%、(576.26±125.36)pg/mL、(174.36±32.63)mmol/L、(68.28±13.32)pg/mL、(149.46±14.22)%、(103.97±11.75)ng/L](P<0.05),NO水平(47.93±5.61)mmol/L显著高于对照组(35.74±5.13)mmol/L(P<0.05)。随访一年,观察组患者房颤复发率(20.00%)显著低于对照组(45.33%)(P<0.05)。结论贝那普利联合阿托伐他汀用药对高血压合并阵发性心房颤动患者有较好的治疗效果,能显著改善心功能,降低血清RDW、NT-proBNP、LDH及Ang-II水平,保护血管内皮功能,减少治疗后房颤复发风险。

Objective To observe the efficacy of benazepril combined with atorvastatin in treating hypertension with parox-ysmal atrial fibrillation,and to explore the effects on cardiac function and levels of serum red blood cell distribution width(RDW),N-terminal pro-brain natriuretic peptide(NT-proBNP),lactate dehydrogenase(LDH)and angiotensin-II(Ang-II).Methods Totally 150 patients with hypertension and paroxysmal atrial fibrillation admitted to the Second Peo-ple's Hospital of Nanyang from January 2018 to January 2020 were selected and divided into control group and observation group according to the random number table method,with 75 cases in each group.The patients in control group were given benazepril,and the patients in observation group were treated with benazepril combined with atorvastatin,and the two groups were treated for 3 months.The efficacy after 3 months of treatment and cardiac function[left atrial inner diameter(LAD),maximum time limit of P wave(Pmax),P wave dispersion(Pd)],serum RDW,NT-proBNP,LDH and Ang-IIand levels of serum von Willebrand factor(vWF),nitric oxide(NO)and endothelin-1(ET-1)before treat-ment and after 3 months of treatment were compared between the two groups.The patients were follow-up for 1 year,and the recurrence rate of atrial fibrillation was observed and recorded in the two groups.Results After3 months of treatment,the efficacy in observation group was significantly higher than that of control group(93.33%vs 82.67%),and the levels of LAD,Pmax,Pd,RDW,NT-proBNP,LDH,Ang-II,vWF and ET-1[(3.42±0.53)cm,(95.26±14.15)ms,(30.75±5.85)ms,(13.24±1.53)%,(525.26±116.85)pg/mL,(153.26±25.74)mmol/L,(59.28±11.36)pg/mL,(132.28±13.05)%,(85.71±10.36)ng/L]were significantly lower than[(3.92±0.60)cm,(105.35±15.53)ms,(34.33±6.74)ms,(13.88±1.36)%,(576.26±125.36)pg/mL,(174.36±32.63)mmol/L,(68.28±13.32)pg/mL,(149.46±14.22)%,(103.97±11.75)ng/L]of control group(P<0.05)while the level of NO with(47.93±5.61)mmol/L was significantly higher than(35.74±5.13)mmol/L of control group(P<0.05).At 1-year follow-up,the recurrence rate of atrial fibrillation in observation group was significantly lower than that of control group(20.00%vs 45.33%)(P<0.05).Conclusion Benazeprilcombined with atorvastatin has good treatment effects on patients with hypertension and paroxysmal atrial fibrillation.And it can significantly improve the cardiac func-tion,reduce the levels of serum RDW,NT-proBNP,LDH and Ang-II,protect the vascular endothelial function,and lower the risk of atrial fibrillation recurrence after treatment.