培哚普利对高血压合并心房颤动患者再次脑卒中的干预

The Effect of Perindopril on Prevention of the Recurrence Stroke in the Hypertension Patients with Atrial Fibrillation

目的 观察长效血管紧张素转换酶抑制剂 (ACEI)培哚普利对高血压合并心房颤动 (AF)患者再次脑卒中的干预作用。方法 选取高血压合并AF、且在 3年内发作脑卒中的患者 35例 ,随机分为对照组与治疗组。对照组继续原来的降压治疗方案 ,治疗组在此基础上再加用培哚普利 2～ 4 (mg/d)。观察血压、脉压、动态血压变化以及再次脑卒中的发生率和死亡率。结果 降压治疗 5年后 ,两组患者血压均显著下降 ,(P <0 0 0 1)。但治疗组血压波动幅度、脉压均明显降低 (P小于 0 0 0 5～0 0 0 1) ,而对照组无明显变化 (P >0 0 5 )。治疗组与对照组再次脑卒中发生率分别为 33 33% (5 / 15 )和 70 % (14 / 2 0 ) ,(P <0 0 0 1) ,RR为 0 4 8;脑卒中死亡率分别为 13 33% (2 / 15 )和 4 5 % (9/ 2 0 ) ,(P <0 0 1) ,RR为 0 30。结论 长效ACEI培哚普利可使血压平稳下降 。

Objective To investigate the effect of perindopril on prevention of the recurrence stroke in the hypertension patients with atrial fibrillation(AF) Methods Thirty five hypertension patients with AF having a history of stroke within the previous 3 years was randomly enrolled into control group(20 cases) and treatment group(15 cases) Anti hypertension therapy with the calcium antagonist, β blocker and diuretic was given to the control group In addition to the conventional anti hypertension therapy, perindopril 2～4(mg/d) was given to the treatment group The ambulatory blood pressure monitoring was carried out on all patients Patients were followed up for 5 years Results After treatment, the causal blood pressure was reduced obviously in two groups( P <0 001), day time and night time SBP and DBP, the pulse pressure(PP) in treatment group was reduced obviously ( P <0 005～0 001, respectively), while no significant change in SBP, DBP and PP was found in the control group( P >0 05) The rate of recurrent stroke and the mortality due to the stroke in the treatment group was obviously lower than that in the control group ( P <0 01, respectively), RR was 0 48, 0 30, respectively Conclusion Perindopril decreased the rate of recurrence stroke and the mortality due to the stroke in the hypertension patients with AF