摘要
目的探讨胺碘酮联合缬沙坦对高血压合并阵发性心房颤动的疗效及其对患者血压、心功能的影响。方法以随机数字表法将重庆市第十三人民医院2019年4月至2021年2月收治的190例高血压合并阵发性心房颤动患者分为两组,各95例。对照组患者接受胺碘酮联合依那普利治疗,观察组患者接受胺碘酮联合缬沙坦治疗,两组均持续治疗6个月。比较两组患者治疗1、3、6个月后时的窦性心律维持率,治疗前后的血压指标、心房颤动发作状况、心功能指标。结果观察组患者治疗1、3、6个月后时窦性心律维持率均显著高于对照组;与治疗前比,治疗后两组患者收缩压、舒张压均显著降低(均P<0.05),但两组间比较,差异均无统计学意义(均P>0.05);与治疗前比,治疗后两组患者心室率、心房颤动发作次数均显著减少,且观察组显著少于对照组,心房颤动发作持续时间均显著缩短,且观察组显著短于对照组;治疗后两组患者左心室射血分数(LVEF)均显著升高,且观察组显著高于对照组;P波最大时限(P_(max))、P波离散度(P_(d))均显著降低,且观察组显著低于对照组(均P<0.05)。结论相较于胺碘酮联合依那普利,胺碘酮联合缬沙坦治疗高血压合并阵发性心房颤动可在发挥降压效果的同时,更有利于改善患者心功能,抑制心房组织与电重构,维持患者窦性心律。
Objective To investigate the efficacy of Amiodarone combined with Valsartan in the treatment of hypertension complicated with paroxysmal atrial fibrillation,and its effect on blood pressure and cardiac function.Methods 190 patients with hypertension complicated with paroxysmal atrial fibrillation who were treated in The Thirteenth People’s Hospital of Chongqing from April 2019 to February 2021 were divided into two groups by random number table,with 95 cases in each group.Patients in the control group were treated with Amiodarone combined with Enalapril,and patients in the observation group were treated with Amiodarone combined with Valsartan,both groups were treated for 6 months.The maintenance rate of sinus rhythm 1,3 and 6 months after treatment,blood pressure index,atrial fibrillation attack status,cardiac function index before and after treatment were compared between the two groups.Results The maintenance rate of sinus rhythm in the observation group was significantly higher than that in the control group 1,3 and 6 months after treatment;compared with before treatment,the systolic and diastolic blood pressure of the two groups decreased significantly after treatment(all P<0.05),but there was no significant difference between the two groups(allP>0.05);compared with before treatment,the ventricular rate and the number of atrial fibrillation attacks in the two groups were significantly less after treatment,and the observation group was significantly less than the control group,the duration of atrial fibrillation attack was significantly shorter,and the observation group was significantly shorter than the control group;after treatment,left ventricular ejection fraction(LVEF)of the two groups were significantly higher,and the observation group was significantly higher than the control group;P wave maximum time limit(P_(max))and P wave dispersion(P_(d))in the two groups were significantly lower,and the observation group was significantly lower than those in the control group(allP<0.05).Conclusion Compared with
作者
杨国文
YANG Guowen(Department of Cardiology,The Thirteenth People’s Hospital of Chongqing,Chongqing 400053,China)
关键词
高血压
阵发性心房颤动
缬沙坦
胺碘酮
Hypertension
Paroxysmal atrial fibrillation
Valsartan
Amiodarone
