螺内酯对阵发性心房颤动的预防和治疗中的作用  

Effect of spirolactone on the prevention and treatment of atrial fibrillation

作　　者：李紫阳[1] 郑松[1] 王刚[1] 

机构地区：[1]上海市交通大学附属瑞金医院卢湾分院心内科,上海200020

出　　处：《临床心血管病杂志》2014年第11期987-989,共3页Journal of Clinical Cardiology

摘　　要：目的:观察醛固酮受体拮抗剂螺内酯在阵发性心房颤动(房颤)复律后的治疗中,对血清醛固酮水平和左心房内径的影响,以及对窦性心律的维持作用。方法:选取阵发性房颤成功复律后的患者99例,随机分为治疗组(50例)和对照组(49例),对照组常规口服胺碘酮及福辛普利,治疗组在上述治疗的基础上再加服螺内酯20mg/d,随诊1年,观察治疗前后血清醛固酮浓度、左心房内径及窦性心律的维持情况。结果:两组患者治疗后血清醛固酮水平[对照组(82.1±27.6)ng/dl,治疗组(79.7±32.5)ng/dl]较治疗前[对照组(145.2±37.1)ng/dl,治疗组(142.9±35.7)ng/dl]均明显下降(P<0.05),但两组间无显著差异(P>0.05)。治疗后治疗组的左心房内径(36.6±9.7)mm明显小于对照组(41.2±7.4)mm(P<0.05),且与治疗前相比[治疗组(45.5±9.2)mm,对照组(44.9±11.1)mm]均有显著缩小(P<0.01)。治疗组患者房颤平均发作次数(4.68±2.51)次明显少于对照组(7.20±5.46)次,治疗组窦性心律的维持率(77.1%)显著高于对照组(52.2%)(P<0.05)。结论:螺内酯对血清醛固酮水平无明显影响,但却可以在一定程度上延缓左心房的扩大,并能减少阵发性房颤的复发,提高窦性心律的维持率。Objective：To observe the effect of spirolactone,the antagonist of aldosterone（ALD）receptor,on the plasma ALD level and left atrial dimension（LAD）in the treatment of paroxysmal atrial fibrillation（AF）after return to sinus rhythm.Method：Ninty-nine patients of paroxysmal AF were divided into control group and spirolactone group.All the patients took aminodarone 200 mg and fosinpril 10 mg per day orally.Besides,spirolactone group were given spirolactone 20 mg per day additionally.The plasma ALD level,the LAD and the rate of sinus rhythm maintenance were measured at before and after the therapeuticcourse of one year.Result：The plasma ALD level of both groups were lower than before,after one year of treatment.But there was no statistical difference between two groups（P〉0.05）.The LAD of spirolactone group was shorter than that of control group after one year（P〈0.05）,and the LAD of both groups were shorter than before（P〈0.01）.The rate of sinus rhythm maintenance of spirolactone group was higher than that of control group（P〈0.05）.Conclusion：Spirolactone has no effect on the plama ALD level,but can prevent atrial enlargement and reduce the recrudescence of AF.

关 键 词：螺内酯 醛固酮 阵发性房颤 

分 类 号：R541.7[医药卫生—心血管疾病]