ACE协助胺碘酮维持房颤患者窦性心律的临床研究  

Angiotensin-converting enzyme inhibitor (ACEI)improve the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation

作　　者：贾新未[1] 邱丕凡[1] 王晓娜[1] 李会敏[1] 高友军 刘良义 

机构地区：[1]河北省职工医学院附属医院心内科,河北保定071000 [2]徐水县人民医院,河北徐水072500

出　　处：《河北职工医学院学报》2006年第1期6-8,共3页Journal of Hebei Medical College for Continuing Education

摘　　要：目的观察血管紧张素转换酶抑制剂能否改善胺碘酮维持房颤患者的窦性心律的效果,并探讨其机制。方法54例持续性心房颤动患者经口服胺碘酮转律成功后,在继续口服胺碘酮的基础上,依是否服用ACEI分为ACEI治疗组(23例)和非ACEI治疗组(31例),随访1年,分别于3个月、6个月、9个月和12个月统计窦性心律的维持情况,于转律后24h、6个月和12个月分别做12导联同步心电图计算P波离散度,于转律后即刻、转律后12个月分别做心脏超声检查测定左心房直径、左心室舒张末期直径、左心室射血分数、E/A比值等。结果在随访的第九个月和第十二月,ACEI治疗组维持窦性心律的效果显著优于非ACEI治疗组(60.87%和29.03%P<0.05;52.17%和22.58%(P<0.05)于随访的第十二个月,ACEI治疗组的P波离散度较非ACEI组显著缩小(37.50±7.54和48.57±3.78P<0.001)。心脏超声随访发现,12个月时ACEI治疗组的左心房直径显著缩小(3.23±0.15和3.50±0.28P=0.009)、左心室舒张功能显著改善(E/A比值)(P=0.039)。结论ACEI有助于改善胺碘酮维持窦性心律的效果,改善心房的电生理特性和心房结构的重构。Objective To investigate whether angiotensin-converting enzyme inhibitor （ACEI） can improve the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation and to probeits mechanisms. Methods 54 patients whose sinus rhythm had just been rebuilt by oral amiodarofle were divided into two groups, that were ACEI group（n = 23） and non- ACEI group （n = 31） .All patients kept on using amiodarone and were followed up for twelve months. The rate of sinus rhythm were calculated at differeflt time points（3, 6, 9 and 12 months） . Diversion of P wave （Pd） were measured at 24 hours, 6 and 12 months after sinus rhythm being rebuilt. UCG examination was also used to explore changes of left atrial diameter （LAD）, left ventricle end- diastolic diameter （LVEDD）, left ventricle ejection fraction （LVEF）and E/A ratio at 24 hours after sinus rhythm being rebuilt and 12 months after the study. Results The rate of sinus rhythm in ACEI group was significantly higher than that in non-ACEI group at 9 and 12 months respectively（60.87% vs 29.03% P 〈0.05; 52.17% vs 22.58% P〈0.05 =.Pd wave was significantly shortened in ACEI group at 12 months （37.50 ± 7.54 vs 48.57 ± 3.78 P = 0. 001） . In ACEI group, the LAD was decreased（3.23 ± 0.15 vs 3.50±0.28 P = 0. 009 ） and the diastolic function of left ventricle（E/A ratio） was improved significantly（P = 0. 039） at 12 months. Conclusions ACEI does improve the effect of amiodarone on fnaintaining sinus rhythm of patients with persistent atrial fibrillation and enhance the improvement of the electrical and morphological remodeling of left atrium.

关 键 词：血管紧张紊转换酶抑制剂 胺碘酮 心房颤动 

分 类 号：R541.7[医药卫生—心血管疾病]