培哚普利与硫氮唑酮联合治疗阵发性心房颤动

Efficacy of Combine Treatment of Perindopril and Diltiazem for Paroxysmal Atrial Fibrillation

为探讨培哚普利 +硫氮唑酮对控制阵发心房颤动 (简称房颤 )发作和左心房扩张的疗效 ,将阵发性房颤分为硫氮唑酮组 (Ⅰ组 )和培哚普利 +硫氮唑酮组 (Ⅱ组 ) ,二组根据左房内径大小分为左房正常组 (Ⅰa=33例、Ⅱa =33例 ) ,左房扩大组 (Ⅰb =34例、Ⅱb =31例 )。Ⅰ组给予硫氮唑酮 30mg 2次 /日或 3次 /日 ;Ⅱ组给予硫氮唑酮 30mg 2次 /日 +培哚普利 4mg 1次 /日。所有患者均治疗 3年。结果 :①各组房颤年发作次数治疗后均有显著减少 (P <0 .0 5 )。②Ⅰb、Ⅱa、Ⅱb组治疗后的房颤持续时间显著缩短 (P <0 .0 5 )。③房颤的年发作次数治疗后 1,2 ,3年间 ,Ⅰa、Ⅱa组显著高于Ⅰb、Ⅱb组 (P <0 .0 5 )。④随治疗时间的延长 ,Ⅱ组左房扩张的增幅明显低于Ⅰ组 (P <0 .0 5 )。结论 :硫氮唑酮和培哚普利 +硫氮唑酮治疗阵发性房颤均可减少房颤的发作 ,但后者优于前者 ,培哚普利 +硫氮唑酮治疗可明显减慢左房的扩张速度。

To evaluate the clinical efficacy of perindopril plus diltiazem in controlling attack of paroxysmal atrial fibrillation(AF) and enlargement of left atrium,131 patients with paroxysmal AF were divided into Diltiazem group( group Ⅰ) and prindopril plus diltiazem group(group Ⅱ), then according to size of left atrium, they were divided into two subgroups (Ⅰa,Ⅱa,Ⅰb and Ⅱb groups).Ⅰgroups received oral diltiazem 60-90 mg a day,Ⅱ groups received diltiazem 60 mg + Perindopril 4 mg a day. The time of treatment was 3 years in all patients. The times of AF episode a year after treatment in all subgroups were significantly shorter than before(P<0.05). The lasting time of AF after treatment in Ⅰb,Ⅱa andⅡb subgroups were significantly reduced than before(P<0.05). The comparisons of the times of AF episode a year and the lasting time of AF between Ⅰa and Ⅱa subgroup at 1st, 2nd, 3rd year had significant differences with Ⅰb, Ⅱb (P<0.05). In Ⅰgroups, left atrium size obviously enlarged with treatment time prolongation, but the enlargement speed of left atrium in Ⅱ groups was significantly lower than Ⅰgroups(P<0.05). Conclusion: Diltiazem and diltiazem+perindopril may reduce episodes of AF, diltiazem + perindopril is superior to diltiazem. perindopril + diltiazem may slow down the speed of left atrial enlargement.