缬沙坦对原发性高血压并阵发性心房颤动患者复率后维持窦性心律的疗效观察

摘要

Objective To observe the influence of valsartan on maintain sinus rhythm after atrial fibrillation cardioversion and maximal time of P waves(Pmax), P dispersion(Pd), left atrial diameter(LADd) in patients with essential hypertension(EH). Methods Seventy-two patients, who had EH combined with AF,were divided into two groups at random: observation group ( valsartan + metoprolol) included 37 patients; contrast group (amlodipine + metoprolol)included 35 patients. Blood pressure,Pmax,Pd,LADd in both groups after 12 months' treatment and sinus rhythm maintenance rate of 3 months, 6 months, 12 months after cardioversion of atrial fibrillation were observed. Results Before treatment,differences in blood pressure,Pmax,Pd,LADd were not statistically significant between two groups (all P > 0. 05). Blood pressure, Pmax, Pd, LADd in both groups were significantly less after 12 months' treatment than before treatment P 0. 05). Conclusion Valsartan works well on maintain sinus rhythm after atrial fibrillation cardioversion in patients with EH. Valsartan can decrease Pmax.Pd, LADd,and at the same time it can prevent the recurrence of AF,independent of its role beyond the antihypertensive effect,the security is good.%目的 观察缬沙坦对原发性高血压(EH)并阵发性心房颤动(PAF)患者复律后维持窦性心律的疗效及P波最大时限(Pmax)、P波离散度(Pd)、左心房内径(LADd)的影响.方法 选择EH并PAF患者72例,随机分为观察组(缬沙坦+美托洛尔)37例和对照组(氨氯地平+美托洛尔)35例,观察两组治疗12个月后血压、Pmax、Pd、LADd及心房颤动复律后3、6、12个月内窦性心律维持率.结果 治疗前两组的血压、Pmax、Pd、LADd比较差异均无统计学意义(均P ＞0.05).观察组治疗12个月后两组的血压、Pmax、Pd、LADd均显著小于治疗前(P＜0.01)；两组治疗后血压差异无统计学意义(均P ＞0.05)；观察组的Pmax、Pd、LADd均显著小于对照组,分别为Pmax(113.4±8.3)ms vs (121.7±8.4) ms、Pd(40.6±7.3) ms vs (44.2±6.9) ms、LADd(33.5±1.4) mm vs (35.8±1.5) ms(P＜0.05或＜0.01).治疗组维持窦性心律的例数在6、12个月明显高于对照组(均P＜0.05)；两组的不良反应发生率差异无统计学意义(x2 =0.126,P＞0.05).结论 缬沙坦用于EH并PAF复律后维持窦性心律效果良好,可减小Pmax、Pd、LADd,同时可部分预防房颤的发生,其作用独立于降压作用之外,安全性好.