缬沙坦联合胺碘酮治疗阵发性心房颤动的效果及对NT-proBNP和hs-CRP水平的影响  

The effect of valsartan combined with amiodarone on paroxysmal atrial fibrillation and serum NT-proBNP and hs-CRP

作　　者：黄芳芳 夏兴凤 张继丰 HUANG Fangfang;XIA Xingfeng;ZHANG Jifeng(Department of Cardiology, the People’s Hospital of Deqing, Huzhou 313200, China)

机构地区：[1]浙江省德清县人民医院心内科,313200

出　　处：《心电与循环》2017年第2期74-76,84,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨单用胺碘酮或联用缬沙坦治疗阵发性心房颤动的效果以及对N末端B型利钠肽原(NT-Pro BNP)和超敏C反应蛋白(hs-CRP)的影响。方法 120例阵发性心房颤动患者随机分成2组,接受胺碘酮治疗(胺碘酮组)以及接受胺碘酮及缬沙坦联合治疗(联合缬沙坦组)。分别测定治疗前、接受治疗6个月及12个月后血浆NT-Pro BNP和hs-CRP水平,同时经胸超声测定左心房内径,随访12个月,终点为心房颤动复发。结果两组患者接受治疗后6个月,l2个月NT-Pro BNP水平均较治疗前降低,差异均有统计学意义(t=7.861、10.513,均P<0.05)。联合缬沙坦组治疗12个月的左心房直径小于胺碘酮组,差异有统计学意义(t=6.914,P<0.05)。两组在治疗第6个月窦性心律维持率差异无统计学意义(P>0.05),治疗第12个月差异有统计学意义(P<0.05)。结论缬沙坦联用胺碘酮较单用胺碘酮可明显降低阵发性心房颤动患者血浆NT-Pro BNP水平,延缓左心房内径扩大,减少心房颤动复发。Objective To investigate the effect of Valsartan with amiodarone on paroxysmal atrial fibrillation and thelevel of serum NT-proBNP and hs-CRP.Methods120patients with paroxysmal atrial fibrillation were enrolled in thestudy.The patients were randomly assigned into amiodarone group treated with amiodarone and amiodarone-valsartangroup treated with amiodarone and valsartan.The level of NT-proBNP and hs-CRP were measured and the diameters ofleft atrium were determined by echocardiogram before,at6and12months after treatment.The primary endpoint was therecurrence of atrial fibrillation.Results The levels of NT-proBNP and hs-CRP were similar before treatment between thetwo groups.The level of NT-proBNP decreased significantly at6and12months after treatment in both groups(t=7.861,10.513,P<0.05).The diameters of left atrium were significantly lower in amiodarone-valsartan group than in amiodaronegroup after12months treatment(t=6.914,P<0.05).The recurrences of atrial fibrillation between the two groups were similarat6months but significantly different at12months after treatment(P<0.05).Conclusion Comparing with amiodarone,combination of valsartan and amiodarone may reduce the serum level of NT-proBNP and recurrence of atrial fibrillation,and delay dilation of left atriumin patients with paroxysmal atrial fibrillation.

关 键 词：缬沙坦 胺碘酮 阵发性心房颤动 N端脑钠素前体 超敏C反应蛋白 

分 类 号：R541.75[医药卫生—心血管疾病]