缬沙坦联合维拉帕米治疗原发性高血压合并阵发性房颤的临床疗效观察

摘要

Objective:To study the effects of valsartan combined with verapamil on paroxysmal atrial fibrillation(PAF) in patient with mild to moderate essential hypertension (EH).Methods:Eighty patients of mild to moderate EH with PAF were randomized to valsartan plus verapamil group or valsartan group. All the patients took amlodipine besylate per day orally.The patients in valsartan plus verapamil groups took valsartan 80-160 mg and verapamil 120-480 mg per day orally.The patients in valsartan group took valsartan 80-160 mg per day orally.The inner diameter of left atrium and the onsets of atrial fibrillation (AF) were measured at before and after the therapeutic 3 th,6 th,and 9 th month.Results:The inner diameter of left atrium in two groups were not significantly changed at the 9 th month,the onsets of AF during the 6 th-9 th month were decreased compared with pre-treatment in two groups and decreased significantly in valsartan plus verapamil group.Conclusion:Valsartan can prevent the enlargement of left atrium of patient with EH complicated with PAF,and reduce the onsets of AF, but the effect of valsartan combined with verapamil is more significant to reduce the onsets of AF.%　　目的：比较缬沙坦联合维拉帕米与单用缬沙坦对原发性高血压合并阵发性心房颤动患者的临床疗效.方法：选择80例原发性高血压(Ⅰ、Ⅱ级)合并阵发性心房颤动患者,均给予苯磺酸氨氯地平基础降压治疗后,随机分为缬沙坦联合维拉帕米组,口服缬沙坦80~160 mg/d,维拉帕米120~480 mg/d；缬沙坦组,口服缬沙坦80~160 mg/d.观察9个月,比较治疗前后左房内径大小与房颤发作次数.结果：治疗6~9个月后,两组左房内径与治疗前比较差异无统计学意义(P>0.05),且两组左房内径比较差异无统计学意义(P>0.05),治疗后房颤发作次数较治疗前减少(P<0.05).但缬沙坦联合维拉帕米组更为有效(P<0.01).结论：应用缬沙坦可延缓高血压并阵发性心房颤动患者左房扩大,防止房颤发作,且联合维拉帕米预防房颤发作效果更明显.