摘要
目的观察贝那普利在持续性心房颤动复律后维持窦性心律中的作用及其对左心房收缩功能的影响。方法80例持续性心房颤动(持续超过7日)患者,药物或电复律后随机分为两组,Ⅰ组40例给予胺碘酮02g每日1次;Ⅱ组40例给予贝那普利10mg每日1次,胺碘酮02g,每日1次;两组均连服6个月。分别于治疗后第1周、2周、1个月、2个月、4个月及6个月复查心电图或动态心电图,观察心房颤动复发情况;复律后次日及6个月后做UCG检查,观察左心房功能变化。结果共71例完成治疗。随访6个月,心房颤动复发Ⅰ组34%(12/35),Ⅱ组为14%(5/36),两组比较差异有统计学意义(P<005),Ⅱ组复律后次日及治疗6个月后,超声测量左心房内径由(43±12)mm缩小为(35±11)mm,治疗前与治疗6个月后比较差异有统计学意义(P<001),而Ⅰ组上述指标比较差异无统计学意义(P>005)。结论贝那普利加胺碘酮用于持续性心房颤动复律后维持窦性心律,较单用胺碘酮更有效,长期服用贝那普利可逆转左心房扩大,降低左心房压,有利于消除心房颤动复发的基础。
Objective: To evaluate the efficacy of benazepril in maintenance of sinus rhythm after cardioversion of atrial fibrillation(AF) and its influence on left atrial function. Methods: Eighty patients with persistent AF(>7days) were randomly divided into two groups after cardioversion using either antiarrhythmic medicines or synchronized direct current. Two groups of patients were compared. GroupⅠwas treated with amiodarone 0.2 qd for 6 months. GroupⅡ was treated with amiodarone 0.2 qd plus benazepril 10 mg qd in the same period. During 6 months of follow-up, electrocardiogram and/or 24-hour Holter recording were performed for detection of recurrence of AF in the first week, second week, first month, second month, fourth month and sixth months. The echocardiography examinations were performed on the next day and 6 months after cardioversion to evaluate changes in left atrial function. Results: After 6 months of follow-up, there were 12 patients (34%) with recurrence of AF in groupⅠ, while only 5 cases(14%) of AF recurrence were found in groupⅡ. There was a significant difference between the two groups(P<0.05). The left atrial diameter(LAD,mm) measured by echocardiography on the next day and 6 months after cardioversion in groupⅡ was (43±12)mm and (35±11)mm respectively, with a significant reduction(P<0.01). While in groupⅠ, LAD did not show any significant reduction after six months(P>0.05). Conclusion: Combination of benazepril and amiodarone is more effective in maintenance of sinus rhythm after cardioversion of AF than amiodarone alone. Long term treatment of benazepril may reverse LA enlargement, decrease LA pressure and prevent the recurrence of AF. [
出处
《新医学》
北大核心
2004年第11期669-671,共3页
Journal of New Medicine
基金
山东省自然科学基金资助(Y2001C02)
