厄贝沙坦氢氯噻嗪在感知R波抑制型起搏器患者中的应用观察  

Application of irbesartan hydrochlorothiazide tablet in patients with ventricular sensing R wave inhibition cardiac pacemakers

作　　者：杨剑峰[1] 张鸿举[1] 梁毅[1] 

机构地区：[1]徐州市第一人民医院心内科,江苏徐州221002

出　　处：《临床荟萃》2011年第13期1105-1107,1110,共4页Clinical Focus

摘　　要：目的观察厄贝沙坦氢氯噻嗪在心室起搏心室感知R波抑制型（VVI）起搏器患者中的应用。方法入选91例患者随机分为观察组47例,对照组44例。观察组术后口服厄贝沙坦氢氯噻嗪75~150 mg/d;对照组未口服厄贝沙坦氢氯噻嗪。随访6个月均检测血浆脑利钠肽（BNP）,并行彩色多普勒超声检查监测左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）和右心室内径（RVD）,进行组内及组间比较。结果观察组患者服药后6个月LVEDD、LVESD、RVD和BNP均比治疗前有明显降低,LVEDD（49.21±7.21）mm vs（46.75±8.05）mm,LVESD（30.31±7.26）mm vs（28.65±6.97）mm,RVD（20.57±1.23）mm vs（18.15±1.16）mm,BNP（232.4±23.36）ng/L vs（168.7±21.65）ng/L,LVEF有明显增高,LVEF（44.85±5.95）%vs（49.67±6.72）%（P〈0.05或〈0.01）;对照组患者随访6个月后LVEDD、LVESD、RVD和BNP均比治疗前升高,LVEDD（50.12±7.52）mm vs（53.46±8.15）mm,LVESD（29.72±7.63）mm vs（32.69±8.05）mm,RVD（19.86±1.62）mm vs（20.25±1.87）mm,BNP（230.5±21.85）ng/L vs（250.6±25.65）ng/L,LVEF有明显降低,LVEF（45.25±6.35）%vs（42.35±4.95）%（P〈0.05）,治疗后两组LVEDD、LVESD、LVEF、RVD和BNP差异均有统计学意义（P〈0.01）。结论 VVI起搏器植入后常规应用厄贝沙坦氢氯噻嗪不失为一种简单、安全、有效的治疗方法,对患者病情及预后十分有益。Objective To observe the application of irbesartan hydrochlorothiazide tablet in VVI cardiac（ventricular pacing ventricular sensing R wave inhibition） pacemaker patients.Methods The patients were randomly divided into two groups,observation group 47 cases,control group 44 cases.The patients in observation group had oral administration of irbesartan hydrochlorothiazide 75-150 mg/d after operation;control group did not have oral irbesartan hydrochlorothiazide.Before pacemaker implantation and in 6 months after implantation,plasma B-type natriuretic peptide（BNP） was determined,color Doppler echocardiogram was used to monitor the left ventricular end-diastolic dimension（LVEDD）,left ventricular end-systolic dimension（LVESD）,left ventricular ejection fraction（LVEF） and right ventricular dimension（RVD）,for inner group and between groups.Results The patients before treatment,after 6 months after taking the drug,showed significantly lower LVEDD,LVESD,RVD,and BNP,LVEDD（49.21±7.21） mm vs（46.75±8.05） mm,LVESD（30.31±7.26） mm vs（28.65±6.97） mm,RVD（20.57±1.23） mm vs（18.15±1.16） mm,BNP（232.4±23.36） ng/L vs（168.7±21.65） ng/L,LVEF increased significantly,LVEF（44.85±5.95）% vs（49.67±6.72）%,the differences were statistically significant（P〈0.05 or 0.01）.The patients in the control group were followed up for 6 months,LVEDD,LVESD,RVD,and BNP were increased,LVEDD（50.12±7.52） mm vs（53.46±8.15） mm,LVESD（29.72±7.63） mm vs（32.69±8.05） mm,RVD（19.86±1.62） mm vs（20.25±1.87） mm,BNP（230.5±21.85） ng/L vs（250.6±25.65） ng/L,LVEF decreased significantly,LVEF（45.25±6.35）% vs（42.35±4.95）%,the differences were statistically significant（P〈0.05）.The two groups after treatment showed significant differences in LVEDD,LVESD,LVEF,RVD,and BNP（P〈0.01）.Conclusion After VVI pacemaker implantation,routine use of irbesartan hydrochlorothiazide is an easy,safe and effective treatment for the condition and prognosis of patients

关 键 词：心律失常 心脏起搏器 人工 抗高血压药 

分 类 号：R544.15[医药卫生—心血管疾病]