螺内酯、厄贝沙坦联合胺碘酮治疗阵发性心房颤动临床观察  

Clinical efficacy of spironolactone or irbesartan combined with amiodarone in treatment of patients with paroxysmal atrial fibrillation

作　　者：仝峰[1] 杨琴[1] 司大妞[1] 

机构地区：[1]河南省焦作市第二人民医院心内科,454001

出　　处：《中国实用医刊》2011年第14期63-65,共3页Chinese Journal of Practical Medicine

摘　　要：目的评价螺内酯、厄贝沙坦联合胺碘酮治疗阵发性心房颤动的疗效。方法将123例阵发性心房颤动患者随机分为胺碘酮＋螺内酯组（A组n=41）、胺碘酮＋厄贝沙坦组（B组n=41）、胺碘酮＋螺内酯＋厄贝沙坦组（C组n=41），随访1．5年，研究的一级终点为房颤复发。比较三组治疗后的窦性心律维持率以及治疗前后、6、12、18个月的左心房内经。结果试验终点时，窦性心律维持率：A组70．0％、B组69．2％、C组87．5％，A组、B组比较差异无统计学意义，C组与A、B两组比较差异有统计学意义（P〈0．05）。A、B两组左房内径大于C组，但差异无统计学意义。结论螺内酯、厄贝沙坦单药加胺碘酮治疗阵发性心房颤动在维持窦性心律方面具有相同的疗效，但两药联合优于单药疗效，并能进一步抑制左心房的扩大。Objective To evaluate the clinical efficacy of spironolactone or/and irbesartan in combination with amiodarone on maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation （PAF）. Methods One hundred and twenty -three patients with PAF were included in the study and randomly divided into three groups： group A （spironolactone plus amiodarone, n =41） ; group B （irbesartan plus amiodarone, n =41 ） ; group C （spironolaetone and irbesartan plus amiodarone, n =41 ）. The left atrial diameter （LAD） was measured with transthoracic echocardiogram at before and after 6,12 and 18 month of treatment. The duration of observation was up to one and half years and the primary end point of the study was the first recurrence of AF. Results At the end of the study, the maintenance of sinus rhythm in group C was higher significantly than that in group A and group B （ 87.5% vs 70.0%o and 69.2% , P 〈 0.05）. Nevertheless, there was no significant difference between group A and group B. LAD in group A and group B was larger than that in group C. Conclusions Amiodarone with spirono- lactone or irbesartan is the same clinical efficacy in sinus rhythm maintenance for PAF. The combination of spironolactone with irbesartan is more effective than monotherapy, and could inhibit the enlargement of left atrium and reduce recurrence rate in patients with PAF.

关 键 词：心房颤动 胺碘酮 螺内酯 厄贝沙坦 

分 类 号：R541.75[医药卫生—心血管疾病]