坎地沙坦对高血压并阵发性房颤病人电生理指标影响  

EFFECTS OF CANDESARTAN ON CARDIAC ELECTROPHYSIOLOGY IN HYPERTENSIVE PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION

作　　者：张庆海[1] 郑方胜[1] 庄绪娜[1] 

机构地区：[1]青岛大学医学院附属医院心内科,山东青岛266003

出　　处：《青岛大学医学院学报》2010年第1期29-31,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨坎地沙坦对高血压并发阵发性心房颤动（房颤）病人的心电生理指标的影响，了解坎地沙坦的抗心律失常效应。方法将60例高血压并阵发性房颤病人随机分成治疗组（30例）和对照组（30例），治疗组给予坎地沙坦，对照组给予非洛地平。分别于治疗前、治疗4个月后窦性心律下测量两组病人体表心电图的最大P波时限（Pmax）和最小P波时限（Pmin），并计算P波离散度（Pd）。同时用24h动态心电图测量其心率变异性，并随访观察4个月内房颤复发相关参数。结果与治疗前相比，治疗组治疗后的Pmax、Pd、低频功率（LF）显著减小，连续R—R间期标准差（SDNN）、平均5分R—R间期标准差（SDANN）、高频功率（HF）值明显上升，差异有显著性（t=2．37～3，09，P〈O．05）。而对照组治疗前后各指标比较差异无显著性（t=0．73～1．26，P〉0．05）。与对照组相比，治疗组治疗后的Pmax、Pd、LF显著减小，SDNN、SDANN、HF值明显上升，差异有显著性（t=2．25～14．35，P〈0．05）；房颤复发率、发作时心室率及发作持续时间降低，差异有显著性（χ2=3．93，t=2．17、4．12，P〈0．05）。结论坎地沙坦能减少高血压并阵发性房颤病人的P波离散度，改善心率变异性，并减少房颤的复发。[摘要]目的探讨坎地沙坦对高血压并发阵发性心房颤动（房颤）病人的心电生理指标的影响，了解坎地沙坦的抗心律失常效应。方法将60例高血压并阵发性房颤病人随机分成治疗组（30例）和对照组（30例），治疗组给予坎地沙坦，对照组给予非洛地平。分别于治疗前、治疗4个月后窦性心律下测量两组病人体表心电图的最大P波时限（Pmax）和最小P波时限（Pmin），并计算P波离散度（Pd）。同时用24h动态心电图测量其心率变异性，并随访观察4个月内房颤复发相关参数。结果与治疗前相�Objective To explore the effect of candesartan on cardiac electrophysiology in essential hypertensive patients with paroxysmal atrial fibrillation （PAF）. Methods Sixty hypertensive patients with PAF were randomly divided into two equal groups： candesartan treatment group and control group. To those in the treatment group, eandesartan was given; to those in the control group, treated with felodipine. Pmax and Pmin of electrocardiogram were measured before and 4 months ai＇ter the treatment and P wave dispersion （Pd） calculated, and meanwhile, 24 hour dynamic ECG was used to check the heart rate variability （HRV）. The PAF recurrence concerning parameters were observed for 4 months. Results In the treatment group： levels of Pd, Pmax and LF significantly decreased after treatment, while the levels of SDNN, SDANN and HF increased compared with that before treatment （t=2.37 3. 09,P〈0. 05）. In the control, there were no significant differences in the corresponding parameters before and after treatment （t =0. 73-1. 26,P〉0. 05）. Compared with the control, the levels of Pd, Pmax and LF significantly decreased and the levels of SDNN, SDANN, and HF increased in the treatment group （t-=2.25 14. 35,P〈0. 05）. The PAF recurrence of the treatment group was significantly lower than that of the control （χ2=3.93;t= 2.17,4. 12;P〈0.05）. Conclusion Candesartan can decrease Pd and PAF recurrence of hypertensive patients with PAF, and improve the heart rate variability.

关 键 词：坎地沙坦 高血压 心房颤动 P波离散度 心率变异性 

分 类 号：R541.75[医药卫生—心血管疾病]