氯沙坦联合胺碘酮对阵发性心房颤动复律及复律后窦性心律维持的影响  

The efficacy of losartan combined with amiodarone in cardioversion of atrial fibrillation and maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation

作　　者：喻学刚[1] 席玉胜[1] 肖波[1] 钟磊[1] 罗显田[1] 

机构地区：[1]解放军421医院心内科,广州510310

出　　处：《中国实用内科杂志》2008年第2期125-127,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的了解氯沙坦联合胺碘酮对阵发性心房颤动的复律效果及复律后窦性心律维持的影响。方法2003年1月至2005年10月将解放军421医院心内科86例非瓣膜病阵发性心房颤动患者分为胺碘酮治疗组和氯沙坦+胺碘酮治疗组,观察治疗24h,3d和7d时心房颤动的转复情况。在心房颤动复律后,继续药物治疗并随访观察1年,评价两组窦性心律的维持效果。结果胺碘酮组44例心房颤动患者治疗24h,3d和7d心房颤动的转复率分别为65.90%,75.00%和86.36%,氯沙坦+胺碘酮治疗组的转复率为66.66%,80.95%和95.23%。两组在7d时心房颤动的转复率差异有显著性意义(P<0.05)。随访1年时两组窦性心律的维持率分别为71.05%和87.50%(P<0.05),两组左房内径分别为(37.45±1.44)mm和(35.83±1.38)mm(P<0.05)。结论氯沙坦联合胺碘酮对阵发性心房颤动的复律及复律后窦性心律维持均优于单用胺碘酮治疗,可能与氯沙坦抑制肾素-血管紧张素系统,降低心脏负荷,抑制心房电及结构重构有关。Objective To investigate the efficacy of losartan combined with amiodarone in cardioversion of atrial fibrillation（AF） and maint of sinus rhythm in patients with paroxysmal AF. Methods From January 2003 to October 2005, a total of 86 consecutive patients with paroxysmal AF in 421 Hospital of PLA were randomly dividid into two group：group A （ amiodarone, n = 44） and. group B （ amiodarone plus losartan n = 42）, The conversion of atrial fibrillation in 24 h, 3 d and 7 d after therapy was investigated. The left atrial diameter was measured with transthoracic echocardiogram at before and after 6,12-months of treatment andyzed up to 12 months. Results The rate of cardioversion of AF is significantly higher in group A than group B at 7 d（86. 36% vs 95.23% ,P 〈0. 05）. Left atrial diameter in group A was significantly larger than group B in 12 months. The maintenance of sinus rhythm in group B was greatly higher than group A at the end of study. Conclusion The results of this study suggest that the combination of amiodarone with losartan is more effective than amiodarone alone in the cardioversion of AF and maintenance of sinus rhythm.

关 键 词：心房颤动 复律 胺碘酮 氯沙坦 

分 类 号：R5[医药卫生—内科学]