厄贝沙坦对高血压病患者左房内径、P波离散度的影响  

Effect of irbesartan on inside diameter enlargement of left atrium and P wave dispersion in patients with hypertension

作　　者：卢辉[1] 王宪沛[2] 李牧蔚[2] 高传玉[2] 高恩民[2] 

机构地区：[1]郑州市第一人民医院,河南郑州450003 [2]河南省人民医院

出　　处：《山东医药》2008年第9期35-37,共3页Shandong Medical Journal

基　　金：河南省重大科技攻关项目(0422030300)

摘　　要：目的探讨厄贝沙坦预防高血压患者房颤的可能机制。方法选择高血压并发左房扩大而不合并左室肥厚的患者52例，服用厄贝沙坦治疗6-12个月。观察治疗前后左房内径（LADD）、左室P波离散度（PD）和左室射血分数（LVEF）的改变。使用双电极电压钳技术记录表达于非洲爪蟾卵母细胞的Kv1.5钾通道电流，不同浓度厄贝沙坦灌流观察其对电流影响。结果经厄贝沙坦治疗后，患者PD、LADD明显减小，LVEF明显增加（P〈0．01）。厄贝沙坦浓度依赖性阻断Kv1．5通道。结论厄贝沙坦对Kv1.5的抑制可能是其减轻心房重构和缩短PD，从而预防房颤发生的电生理学基础。Objective To explore possible mechanisms of irbesartan in preventing atrial fibrillation in patients with hypertension. Methods 52 cases with left atrial enlargement, without left ventricular hypertrophy were treated with irbesartan for 6-12 months. Left atrial diameters （LADD）, P wave dispersions （PD） and left ventricular ejection fraction （LVEF） were observed before and after treatment. Kv1. 5 potassium channel current expressed in xenopus oocytes was recorded using standard two-microelectrode voltage clamp techniques, and then superperfused with irbesartan of different concentration to observe the effect on channel current. Results After treatment with irbesartan, PD and LADD were significantly decreased, and LVEF was significantly increased（ P 〈 0. 01 ）. Irbesartan blocked Kv1. 5 channels in a concentrationdependent manner. Conclusion The blockade of irbesartan on Kv1. 5 current may be the electric mechanisms in preventing atrial fibrillation through inhibiting atrial remodeling and decreasing PD.

关 键 词：心房颤动 厄贝沙坦 高血压 P波离散度 

分 类 号：R544.1[医药卫生—心血管疾病]