摘要
目的对比替米沙坦与硝苯地平预防高血压患者心房颤动复发的疗效。方法选择高血压合并阵发性心房颤动患者98例，按随机数字表法分为替米沙坦组和硝苯地平组，每组49例。替米沙坦组予替米沙坦80mg／d，硝苯地平组予硝苯地平控释片30mg／d，治疗不达标者根据个体情况加用氢氯噻嗪或替米沙坦／硝苯地平控释片剂量加倍，均持续治疗18个月。观察两组心房颤动复发情况及首次复发时间，治疗前后记录心脏参数：左心房内径（LAD）、左心室舒张末期内径（LVDD）、左心室舒张末期后壁厚度（LVPWT）、舒张末期室间隔厚度（IVST）、左心房体积指数（LAVI）及左心室质量指数（LVMI）。结果两组患者治疗后血压均较治疗前显著降低，差异有统计学意义（P〈0．05），但两组间治疗后比较差异无统计学意义（P〉0．05）。治疗后，替米沙坦组与硝苯地平组心房颤动复发率、首次心房颤动复发时间比较差异均无统计学意义（P〉0．05）；但替米沙坦组持续性心房颤动发生率显著低于硝苯地平组[4．1％（2／49）比16．3％（8／49）]，差异有统计学意义（P=0．045）。治疗前两组心脏参数比较差异无统计学意义（P〉0．05）；治疗后两组心脏参数均较治疗前显著降低，差异有统计学意义（P〈0．05）；而且，治疗后替米沙坦组LAD、LVPwT、LAVI及LVMI均显著低于硝苯地平组[（37．6±2．9）mm比（38．9±2．4）mm、（11．6±1．0）mm比（12．0±0．9）mm、（22．0±3．6）ml／m。比（23．9±4．2）ml/m^2、（120．4±18．2）g／m^2比（129．5±19．2）g／m^2]，差异有统计学意义（P〈0．05）。结论硝苯地平和替米沙坦均可有效降低高血压伴心房颤动患者的血压，但替米沙坦在阻止阵发性心房颤动向持续性心房颤动转化、延缓心房扩张、改善心肌重构更具优势。
Objective To compare the prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine. Methods Ninety-eight cases of hypertensive with paroxysmal atrial fibrillation patients were enrolled and divided into telmisartan group and nifedipine group with 49 cases each by random digits table method. Telmisartan group was given telmisartan 80 mg/d, nifedipine group was given nifedipine 30 mg/d. Dose of the drug needed to be adjusted according to individual condition until achieving the target. Followed-up for 18 months. Observed two groups of recurrence of atrial fibrillation and the recurrence time for the first time, recorded before and after the treatment of cardiac parameters： including left atrial diameter （LAD）, left ventricular end diastolic diameter （LVDD）, left ventricular posterior wall thickness （LVPWT）, interventricular septum thickness （IVST）, left atrial volume index（LAVI） and left ventricular mass index（LVMI）. Results The blood pressure after treatment in two groups was lower than that before treatment, there was statistically significant difference （P 〈 0.05 ）,but there was no statistically significant difference between two groups （P 〉 0.05）. After treatment, the recurrence of atrial fibrillation, atrial fibrillation recurrence time for the first time in two groups had no statistical significance （P 〉 0.05）. But the incidence of persistent atrial fibrillation in telmisartan group was significantly lower than that in nifedipine group [4.1% （2/49） vs. 16.3% （8/49）],there was statistically significant difference （P = 0.045）. The cardiac parameters between two groups before treatment had no significant difference （P 〉 0.05 ）. After treatment, the cardiac parameters in two groups were significantly reduced, there were statistically significant differences （P 〈 0.05 ）. Moreover, the LAD, LVPWT, LAVI and LVMI in telmisartan group after treatment were significantly lower than those in nifedipine
出处
《中国医师进修杂志》
2013年第27期24-27,共4页
Chinese Journal of Postgraduates of Medicine
关键词
高血压
心房颤动
硝苯地平
替米沙坦
Hypertension
Atrial fibrillation
Nffedipine
Telmisartan
