缬沙坦对高血压合并心房颤动发生率、左心室肥厚逆转和左心室舒张功能的影响  

Effects Of Valsartan on the occur rate of essential hypertension complicated with atrial fibrillation,inhibiting left ventricular hypertrophy and left ventricular diastolic fuction

作　　者：陈茜 曲环 彭长农[3] 张小波 邹辉建 邵黄河 

机构地区：[1]广东省深圳市龙岗区布吉人民医院急诊科,518112 [2]北大中心医院心内科 [3]孙逸仙心血管医院心内科 [4]深圳市龙岗区布吉人民医院心内科 [5]深圳市龙岗区布吉人民医院特诊科

出　　处：《临床内科杂志》2008年第4期244-247,共4页Journal of Clinical Internal Medicine

基　　金：广东省深圳市科技计划项目(编号:200603010)

摘　　要：目的探讨缬沙坦对高血压合并心房颤动发生率、逆转左心室(左室)肥厚和左室舒张功能的影响。方法高血压合并房颤经电转复或药物恢复窦性心律患者210例,随机分为缬沙坦组和氨氯地平组。观察两组患者1年内房颤复发率及其与高血压左室肥厚的关系;比较治疗前后心脏超声参数:左室舒张末期室间隔厚度(IVST)、左室后璧厚度(LVPWT)、左室舒张末期内径(LVEDd)、左房前后径(LADd)、左室质量指数(LVMI)和左心室舒张功能指标;随访治疗期间心脑血管事件的发生。结果缬沙坦组房颤复发率较氨氯地平组明显降低(P<0.01)。LVH组94例与非LVH组47例房颤发生率分别为66.67%和33.34%(P<0.01)。治疗后缬沙坦组IVST、LVP-WT、LVEDd、LADd、LVMI较治疗前均有明显下降(P<0.01),氨氯地平组只有LVMI较治疗前有明显下降(P<0.01)。治疗后左室舒张功能指标缬沙坦组明显优于氨氯地平组(P<0.01)。治疗期间缬沙坦组心脑血管事件的发生率明显低于氨氯地平组(P<0.01)。结论(1)缬沙坦与胺碘酮联合应用能减少高血压合并房颤的复发;(2)缬沙坦能够逆转原发性高血压引起的左室肥厚,改善左室舒张功能,降低房颤患者心脑血管事件的发生。Objective To investigate the effects of Valsartan on the occur rate of essential hypertension complicated with atrial fibrillation,inhibiting left ventricular hypertrophy and left ventricular diastolic fuction（LVDF）.Methods Two hundreds and ten patients with essential hypertension complicated with AF who were recovered from the sinus rhythm throught electrotherapy or medicines were randomly divided into ARB group and CCB group.The recurrent rates of AF and the left ventricular hypertrophy and the occur rate of cardiocerebral events in two groups were compared.IVST,LVPWT,LVEDd,LADd,LVMI,LVDF were measured in two groups before and after the treatment by Droppler ultrasound.Results The recurrent rate of AF and the occur rate of cardiocerebral events in ARB group decreased significantly compared with that in CCB group（P〈0.01）.The occur rate of AF in the LVH group（94）was 66.67%,while in the non LVH group（47）was 33.34%（P〈0.01）.After treatment IVST,LVPWT,LVEDd,LADd,LVMI in ARB group drecreased significantly compared with those before treatment（P〈0.01）.In CCB group only LVMI drecreased significantly（P〈0.01）.LVDF after treatment in ARB group was obviously improved compared with that in CCB group（P〈0.01）.Conculsion Valsartan and aminodarone combination can reduce the recurrent rate of hypertension complicated with AF,and can effectively inhibit left ventricular hypertrophy,and improve left ventricular diastolic function.Valsartan is helpful in decreasing the occur rate of cardiocerebral events in Af patients.

关 键 词：血管紧张素Ⅱ受体拮抗剂 高血压病 心房颤动 左心室肥厚 

分 类 号：R541.3[医药卫生—心血管疾病]