维尔亚和依那普利对原发性高血压患者心电图P波离散度的影响

目的 观察血管紧张素Ⅱ受体拮抗剂和血管紧张素转化酶抑制剂对原发性高血压（EH）患者心电图P波时限和离散度的影响。方法 EH患者68例,随机分为两组,维尔亚4 mg/d和依那普利10 mg/d,血压控制不良者可加用利尿剂和钙离子拮抗剂,共观察6个月。分别于用药前后测定12导联体表心电图中P波时限和P波离散度。结果 用药后两组均可使EH患者心电图P波时限和P波离散度减小,组间比较显示,维尔亚组的作用更优于依那普利组。结论 维尔亚对EH患者心电图P波时限和P波离散度的作用强于依那普利。     

P波离散度与阵发性心房颤动及房性心律失常的关系

目的 :探讨 P波离散度与阵发性 (含特发性 )心房颤动 (AF)及房性心律失常 (AR,含频发性房性期前收缩或多源性房性期前收缩伴或不伴短阵房性心动过速 )的关系。方法 :观察测量30例 AF(AF组 )和 30例 AR患者 (AR组 ) P波离散度、P波最大时限 ,并与 34例正常人 (对照组 )对比分析。结果 :AF组和 AR组的 P波离散度、P波最大时限与对照组比较差异均有极显著性意义 (P <0 .0 1 )。且两组患者中多数患者 P波离散度≥ 40 ms。结论 :P波离散度是预测 AF和 AR体表心电图的一个可靠指标     

瑞舒伐他汀对病窦综合征双腔起搏术后阵发性心房颤动的作用

目的评价瑞舒伐他汀对病窦综合征(SSS)双腔起搏后阵发性心房颤动(AF)的作用。方法将78例双腔起搏术后1个月仍有阵发性AF的SSS患者随机分为治疗组(n=39)和对照组(n=39)。在治疗基础疾病的基础上,治疗组给予瑞舒伐他汀10mg,每晚顿服,对照组不予他汀药物治疗。随访1年,观察AF发作次数(次/天)、AF负荷(h/d)及血清C反应蛋白(CRP)水平。结果治疗组起搏术后1年AF发作次数、AF负荷、CRP水平明显低于对照组(4.10±3.84次/天vs9.20±6.25次/天,0.484±0.288h/dvs0.791±0.326h/d,2.98±2.30mg/Lvs6.50±4.03mg/L,P均0.05),亦低于用药前(P均0.001),而对照组上述指标无变化。结论瑞舒伐他汀可有效抑制SSS双腔起搏后阵发性AF的发生,降低炎症因子CRP水平。     

替米沙坦联合瑞舒伐他汀对2型糖尿病合并冠心病患者肝细胞生长因子和过氧化物酶体增殖物激活受体γ的影响

目的探讨替米沙坦联合瑞舒伐他汀对T2DM合并冠心病患者血清肝细胞生长因子(HGF)及其受体(c-met)和PPAR-γ表达水平的影响。方法选取95例T2DM合并冠心病患者,将其分为对照组、替米沙坦组和替米沙坦联合瑞舒伐他汀组。检测各组血清HGF、c-met和PPAR-γ水平。结果与对照组比较,替米沙坦组、替米沙坦联合瑞舒伐他汀组治疗后HGF[(338.96±36.51)vs(241.56±29.88)vs(173.23±32.25)pg/ml]、c-met[(0.657±0.162)vs(0.489+0.093)vs(0.247±0.075)ng/m1]和PPAR-γ[(53.76±11.97)vs(35.12±9.66)vs(23.91±6.87)pg/ml]水平降低(P0.05),且替米沙坦联合瑞舒伐他汀组上述指标较替米沙坦组下降更明显(P0.05)。结论替米沙坦与他汀类药物联合应用可能改善T2DM合并冠心病患者血管的内皮损伤,为临床防治糖尿病早期冠状动脉粥样硬化提供了新的思路。     

瑞舒伐他汀对阵发性心房颤动复律后维持窦性心律及P波离散度的影响

目的 观察瑞舒伐他汀对阵发性心房颤动（PAF）复律后维持窦性心律及P波离散度的影响.方法 选择经静脉注射胺碘酮转复后的PAF患者80例随机分为2组,对照组38例单独口服胺碘酮;治疗组42例在对照组治疗的基础上加用瑞舒伐他汀口服.两组疗程均为12个月.结果 治疗组治疗后各时间段的C-反应蛋白（CRP）水平均显著低于对照组（P均〈0.01）;两组患者治疗2周后复律成功率差异无统计学意义（P〉0.05）,治疗后1、6、12个月治疗组窦性心律维持率均显著高于对照组（P均〈0.05）;治疗组最大P波时限（P（max））、P波离散度（Pd）比治疗前和对照组显著缩短（P均〈0.05）.瑞舒伐他汀的不良反应轻微.结论 瑞舒伐他汀联合胺碘酮用于阵发性心房颤动复律后维持窦性心律效果良好,显著降低CRP水平,显著缩短最大P波时限和P波离散度,安全性好.     

依折麦布联合瑞舒伐他汀在2型糖尿病合并高脂血症患者中的疗效

目的比较使用瑞舒伐他汀联合依折麦布和加大他汀剂量治疗他汀降脂治疗不能达标的2型糖尿病患者的疗效。方法入选2012年9月至2013年9月于辽宁省朝阳市第二医院心内科就诊的2型糖尿病患者同时低密度脂蛋白胆固醇(LDL-C)100 mg/d L,服用瑞舒伐他汀(2.5 mg/d)12周后仍LDL-C80 mg/d L86例,其中男性58例,女性28例,平均年龄为(64.76±11.3)岁。随机分为瑞舒伐他汀+依折麦布组(43例)和瑞舒伐他汀组(43例)。瑞舒伐他汀+依折麦布组在常规治疗基础上每天服用2.5 mg瑞舒伐他汀加10mg依折麦布;瑞舒伐他汀组在常规治疗基础上每天服用10 mg瑞舒伐他汀,均连续治疗12周。主要观察治疗前后血脂水平、肌酸激酶、肝功能、血糖及胰岛素等的变化。结果与本组基线水平比较,两组治疗后LDL-C、三酰甘油(TG)、总胆固醇(TC)下降,LDL-C80 mg/d L、LDL-C100 mg/d L比例增加,差异具有统计学意义(P均0.05)。与瑞舒伐他汀组治疗后比较,瑞舒伐他汀+依折麦布组治疗后LDL-C[(90±18)mg/d L vs.(72±15)mg/d L]、TG[(122±12)mg/d L vs.(103±13)mg/d L]、TC[(146±13)mg/d L vs.(138±16)mg/d L]下降,差异具有统计学意义(P均0.05)。瑞舒伐他汀+依折麦布组较瑞舒伐他汀组LDL-C80 mg/d L、LDL-C100 mg/d L比例增加,差异具有统计学意义(P均0.05)。两组治疗前、治疗后谷草转氨酶、谷丙转氨酶、胃肠道不良反应比较,差异无统计学意义(P均0.05)。结论他汀治疗后血脂不达标的2型糖尿病患者,使用瑞舒伐他汀联用依折麦布效果优于单用瑞舒伐他汀加强治疗。     

瑞舒伐他汀治疗老年不稳定型心绞痛疗效观察

目的观察瑞舒伐他汀对70岁以上不稳定型心绞痛(UA)患者血脂及临床疗效。方法 184例UA患者随机分为随机分为瑞舒伐他汀5mg/d组(A组)与瑞舒伐他汀10mg/d组(B组)。分析比较不同剂量瑞舒伐他汀治疗前和治疗后8周总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)的变化,同时观察UA患者临床效果。结果瑞舒伐他汀5mg/d与瑞舒伐他汀10mg/d均能显著降低TC(P<0.01)、LDL-C(P<0.01),瑞舒伐他汀10mg/d作用强于瑞舒伐他汀5mg/d(P<0.05),瑞舒伐他汀5mg/d与瑞舒伐他汀10mg/d均能升高HDL-C,并降低TG,两组间比较无统计学意义。结论瑞舒伐他汀5mg/d与瑞舒伐他汀10mg/d均能显著降低TC、LDL-C,但瑞舒伐他汀10mg/d作用优于瑞舒伐他汀5mg/d。     

P波离散度与冠脉搭桥术后阵发性心房颤动关系的临床探讨

目的 探讨P波离散度与冠脉搭桥术后阵发性心房颤动(阵发性房颤)的关系.方法 选取2004年-2007年我院心脏中心住院的冠脉搭桥术后并发阵发性房颤病人63例为阵发性房颤组,同期住院的冠脉搭桥术后未发生阵发性房颤病人71例为对照组,记录12导联同步心电图,测量术前心电图P波最大时限(Pmax)、P波最小时限(Pmin),计算P波离散度(Pdisp),并进行比较分析.结果 阵发性房颤组与对照组比较,P波最大时限分别为(122.22±8.70)mm和(103.24±11.18)mm31,P波最小时限分别为(71.11±7.43)mm和(64.51±10.25)mm,P波离散度分别为(50.79±6.30)mm和(38.31±5.85)mm,两组间比较有统计学意义(P＜0.001).结论 P波离散度为预测冠脉搭桥术后阵发性心房颤动的一个体表心电图的可靠指标.     

不同剂量瑞舒伐他汀对不稳定性心绞痛患者支架置入术后心肌损伤的保护和抗炎作用

目的探讨不同剂量的瑞舒伐他汀对不稳定型心绞痛(UA)患者支架置入术后心肌损伤的保护和抗炎作用。方法 150例UA并经皮冠状动脉介入(PCI)治疗的患者随机分为A组(阿托伐他汀20 mg/d)、B组(瑞舒伐他汀10 mg/d)、C组(瑞舒伐他汀20 mg/d),每组50例。三组患者连续3 d于睡前服用他汀类药物直至行PCI术,术后继续给予常规治疗并观察术前及PCI术后48 h外周血检测超敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白(c Tn I)的水平,检测术后48 h的外周血CD4+T细胞的凋亡情况,同时比较PCI术后1个月与入院时血高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和总胆固醇(TC)的水平。结果三组患者术前hs-CRP、CK-MB、c Tn I、TC、TG、HDL-C和LDL-C水平无明显差异(P0.05),而术后较术前相比有明显的改变(P0.05)。瑞舒伐他汀20 mg/d患者术后48 h hs-CRP、CK-MB、c Tn I、TC、TG、HDL-C和LDL-C水平与瑞舒伐他汀10 mg/d和阿托伐他汀20mg/d相比有显著的改善(P0.05);而瑞舒伐他汀10 mg/d和阿托伐他汀20 mg/d两组患者上述水平无明显差异(P0.05)。PCI术后48 h瑞舒伐他汀10 mg/d组患者CD4+T细胞凋亡比例明显高于阿托伐他汀20 mg/d组患者(P0.05),而瑞舒伐他汀20 mg/d组患者CD4+T细胞凋亡比例明显高于10 mg/d的患者。结论瑞舒伐他汀10 mg/d的常规剂量具有降脂,升高HDL-C水平、保护心肌和抗炎作用,而20 mg/d强化治疗能够显著增加PCI术后对心肌的保护和抗炎作用。     

瑞舒伐他汀治疗高血脂并高尿酸血症患者的疗效研究

目的:评价瑞舒伐他汀对高血脂并高尿酸血症患者的疗效和安全性。方法:选择我院住院治疗的高血脂合并高尿酸血症患者88例,随机均分为瑞舒伐他汀组(10mg/d)和阿托伐他汀组(20mg/d),治疗8周。观察两组治疗前后血脂和血清尿酸(SUA)水平的变化。结果:与治疗前相比,两组患者治疗8周后血脂(除高密度脂蛋白-胆固醇)和SUA水平均明显降低(P均0.01);与阿托伐他汀组比较,瑞舒伐他汀组治疗后总胆固醇[(4.87±0.47)mmol/L比(4.48±0.53)mmol/L]水平降低更显著(P=0.04),两组间治疗后SUA水平无显著差异(P0.05)。两组均未出现比较严重的副作用。结论:瑞舒伐他汀在降低高血脂患者血脂水平同时亦可降低血清尿酸水平,且具有良好的安全性和耐受性。     

阿托伐他汀与瑞舒伐他汀对阵发性心房颤动患者射频消融术后复发率及心房电重构的影响比较

目的 比较阿托伐他汀与瑞舒伐他汀对阵发性心房颤动患者射频消融术后复发率及心房电重构的影响.方法 选择2019年1月至2020年6月于郑州大学附属洛阳中心医院心内科接受射频消融的阵发性房颤患者120例,采用随机数字表法分为阿托伐他汀组、瑞舒伐他汀组以及无他汀治疗组,每组40例.三组术后均接受口服奥美拉唑治疗1个月,华法林...     

The comparative effects of telmisartan and ramipril on P-wave dispersion in hypertensive patients: a randomized clinical study

BACKGROUND: Prolongation of P-wave times and increase of P-wave dispersion (PWD) were shown to be independent predictors of atrial fibrillation (AF). Angiotensin II receptor blockers (AARBs) and angiotensin-converting enzyme inhibitors (ACEIs) have beneficial effects on atrial conduction times. However, there are not enough data about the comparative effects of those drugs on PWD. HYPOTHESIS: We aimed to compare the effects of telmisartan and ramipril on PWD after 6-month treatment in hypertensive patients. METHODS: In all, 100 newly diagnosed hypertensive patients were enrolled in the study and were randomly assigned to two groups. Group 1 and Group 2 each consisted of 50 patients, taking daily doses of 80 mg telmisartan and 10 mg ramipril, respectively. Twelve-lead surface electrocardiograms (ECG) were recorded from all patients before and after 6-month drug therapy. The P-wave duration (Pdur) measurements were calculated from the 12-lead surface ECG. RESULTS: When pretreatment PWD and Pmaximum values were compared with post-treatment values, a statistically significant decrease was found in both groups after 6 months (Group 1 and 2; p < 0.001 for PWD and Pmaximum). P-wave dispersion and Pmaximum values after treatment in Group 1 were statistically significantly lower than those in Group 2 after the 6-month treatment period (p = 0.01 for PWD; p = 0.008 for Pmaximum). CONCLUSIONS: Telmisartan has a much greater lowering effect on PWD and Pmaximum values than ramipril. This finding may be important in the prevention of AF in hypertensive patients.     

Central blood pressure lowering effect of telmisartan‐rosuvastatin single‐pill combination in hypertensive patients combined with dyslipidemia: A pilot study

This multicenter, phase 4, Prospective Randomized Open, Blinded End‐point (PROBE) study aimed to evaluate safety and efficacy of telmisartan/rosuvastatin single‐pill combination (SPC) therapy on lowering central blood pressure (BP) compared with telmisartan monotherapy in hypertensive patients with dyslipidemia in Korea. Study was terminated earlier than planned due to COVID‐19 pandemic, thus should be considered as a pilot study. Among 125 patients who met the inclusion criteria of hypertension and dyslipidemia (defined as 10‐year Atherosclerotic Cardiovascular Disease risk score over 5%), 80 patients went through 4‐week single‐group run‐in period with telmisartan 40–80 mg, then randomized to telmisartan 80 mg + rosuvastatin (10 or 20 mg) SPC group or telmisartan 80 mg monotherapy group. The central/brachial BP, brachial‐ankle pulse wave velocity (baPWV), and augmentation index (AIx) were assessed at baseline and 16 weeks later. Mean brachial SBP changed from 135.80 ± 14.22 mmHg to 130.69 ± 13.23 mmHg in telmisartan/rosuvastatin group and from 134.37 ± 12.50 mmHg to 133.75 ± 12.30 mmHg in telmisartan monotherapy group without significant difference (between‐group difference p = .149). Mean central SBP were reduced significantly in the telmisartan/rosuvastatin group with change from 126.72 ± 14.44 mmHg to 121.56 ± 14.56 mmHg while telmisartan monotherapy group showed no significant change (between‐group difference p = .028). BaPWV changed from 1672.57 ± 371.72 m/s to 1591.75 ± 272.16 m/s in telmisartan/rosuvastatin group and from 1542.85 ± 263.70 m/s to 1586.12 ± 297.45 m/s in telmisartan group with no significance (between‐group difference p = .078). Change of AIx had no significant difference (between‐group difference p = .314). Both groups showed excellent compliance rate of 96.9 ± 4.5% with no significant difference in adverse rate. Telmisartan/rosuvastatin SPC therapy was more effective in lowering central BP compared with the telmisartan monotherapy. The results of this study showed benefit of additive statin therapy in hypertensive patients combined with dyslipidemia.     

Efficacy and safety of rosuvastatin 40 mg versus atorvastatin 80 mg in high-risk patients with hypercholesterolemia: results of the POLARIS study

POLARIS investigated the efficacy and safety of rosuvastatin 40 mg and atorvastatin 80 mg in high-risk patients with hypercholesterolemia. Patients (n=871) were randomized to rosuvastatin 40 mg/day or atorvastatin 80 mg/day for 26 weeks. The primary endpoint was percentage change in LDL-C levels at 8 weeks. Secondary assessments included safety and tolerability, NCEP ATP III LDL-C goal achievement, change in other lipids and lipoproteins at 8 and 26 weeks, and health economics. Mean LDL-C levels were reduced significantly more with rosuvastatin 40 mg than with atorvastatin 80 mg at 8 weeks (-56% versus -52%, p<0.001). The proportion of patients achieving the NCEP ATP III LDL-C goal at 8 weeks was significantly higher in the rosuvastatin 40 mg group (80% versus 72%, p<0.01). Significant differences in the change from baseline in high-density lipoprotein cholesterol (HDL-C) (+9.6% versus +4.4%) and apolipoprotein (Apo)A-I levels (+4.2 versus -0.5) were observed between rosuvastatin and atorvastatin (all p<0.05). Both treatments were well tolerated. Based on a US analysis, rosuvastatin used fewer resources and delivered greater efficacy. Intensive lipid-lowering therapy with rosuvastatin 40 mg/day provided greater LDL-C-lowering efficacy than atorvastatin 80 mg/day, enabling more patients to achieve LDL-C goals. Rosuvastatin may therefore improve LDL-C goal achievement in high-risk patients with hypercholesterolemia.     

Efficacy and tolerability of a fixed-dose combination of telmisartan plus hydrochlorothiazide in patients uncontrolled with telmisartan monotherapy.

The antihypertensive effects of a telmisartan 80 mg/hydrochlorothiazide (HCTZ) 12.5 mg fixed-dose combination and telmisartan 80 mg monotherapy were compared in patients with a history of mild-to-moderate essential hypertension and inadequate BP control (DBP > or = 90 mm Hg) following 8 weeks of telmisartan monotherapy. At the end of this period, 491 patients (62.9% men; mean age 55.3 years) whose DBP was > or = 90 mm Hg were double-blind randomised to once-daily telmisartan 80 mg/HCTZ 12.5 mg (n = 246) or telmisartan 80 mg (n = 245). Trough (24 h post-dose) clinic BP was measured after 4 and 8 weeks of double-blind therapy. At the end of double-blind treatment, patients receiving telmisartan 80 mg/HCTZ 12.5 mg had significant additional decrements in clinic SBP/DBP over telmisartan 80 mg of -5.7/-3.1 mm Hg (P < 0.01). Most of the additional effect occurred during the first 4 weeks of treatment. The proportion of patients with normalised BP (SBP < 140 mm Hg and DBP < 90 mm Hg) was significantly greater in the telmisartan 80 mg/HCTZ 12.5 mg group than the telmisartan 80 mg group (41.5%vs 26.1%;P < 0.05). Both treatments were well tolerated. The incidence of adverse events was similar except for diarrhoea, which occurred more frequently in the telmisartan 80 mg/HCTZ 12.5 mg group, and oedema, which occurred more frequently in the telmisartan group. Our results indicate that a telmisartan 80 mg/HCTZ 12.5 mg fixed-dose combination confers significant additional BP reductions compared with continuation of telmisartan monotherapy in non-responders.     

替米沙坦对老年高血压患者尿酸和超敏C反应蛋白的影响

目的探讨替米沙坦对老年原发性高血压合并高尿酸血症患者的治疗作用以及对超敏C反应蛋白（hs-CRP）的影响。方法选择66例老年1～2级原发性高血压患者,血尿酸（BUA）420～530μmol／L,随机分成2组：替米沙坦组35例（替米沙坦40-80mg／d）、对照组31例（苯磺酸氨氯地平5～10mg／d）,两组患者用药2周末测血压。治疗12周后观察收缩压、舒张压、空腹BUA、hs-CRP水平。结果治疗2周末两组患者血压开始下降,4周后血压趋于稳定,与治疗前比较差异有统计学意义（P〈0．01）,治疗12周后两组血压比较差异无统计学意义。替米沙坦组治疗12周后BUA、hs—CRP水平较治疗前下降（P〈0．01）,对照组hs—CRP较治疗前下降（P〈0．01）。结论替米沙坦除有良好的降压作用外,尚能有效地降低原发性高血压患者hs—CRP、BUA水平。     

Comparison of effects of olmesartan and telmisartan on blood pressure and metabolic parameters in Japanese early-stage type-2 diabetics with hypertension.

Angiotensin II type-1 receptor blockers (ARBs) are regarded as first-line treatments for type-2 diabetes with hypertension. Despite the availability of various types of ARBs, there are no comparative studies of their effects on patients with diabetes. In this open-label prospective crossover study, we compared the effects of olmesartan (20 mg/day) and telmisartan (40 mg/day). Twenty Japanese early-stage type-2 diabetes patients with hypertension treated with valsartan (80 mg/day) for at least 8 weeks were recruited to this study. At study entry, valsartan was changed to olmesartan (20 mg/day) or telmisartan (40 mg/day) and administered for 8 weeks. The drugs were then switched and treatment was continued for another 8 weeks. We analyzed the blood pressure lowering effects of each drug by 24-h ambulatory blood pressure monitoring at 0, 8, and 16 weeks. Simultaneously, we measured metabolic parameters and inflammation markers. Olmesartan lowered mean systolic and diastolic blood pressure more significantly than did telmisartan. While there were no differences between the groups in metabolic parameters, including HbA1c and adiponectin, the decreases in serum interleukin-6 and highly sensitive C-reactive protein were more significant by olmesartan treatment. Our results indicate that olmesartan has more potent arterial blood pressure lowering and anti-inflammatory effects than telmisartan.     

依那普利治疗高血压并阵发性房颤的超声改变和疗效

目的：探讨依那普利对原发性高血压并阵发性房颤患者的干预作用并观察P波最大时限（Pmax）、P波离散度（Pd）、左心房内径（LAD）的变化。方法：治疗组给予依那普利5mg/d,服用1周,无效者在第2周开始将依那普利加大剂量至10～15mg/d,患者出院后,每1周门诊随访1次,共6个月;对照组给予吲达帕胺2.5mg/d,随访同上。用药期间及用药后观察患者的临床症状及体征变化,记录房颤的发作次数和持续时间,并观察生化指标的改变,服药6个月后复查12导联同步ECG及心脏彩超。结果：（1）治疗后两组有显著的降压效果,但无显著差异（P〉0.05）;（2）治疗6个月后,①窦性心律时,吲达帕胺组治疗前后Pmax,Pd无显著性差异（P〉0.05）;依那普利组则Pmax,Pd均显著降低（P〈0.05）;②LAD：吲达帕胺组较治疗前明显扩大（P〈0.05）,而依那普利组则无明显改变（P〉0.05）;（3）在随访的6个月中,依那普利组平均每例房颤发作次数显著少于吲达帕胺组（6.1±2.5）次∶（7.6±2.8）次,P〈0.05;平均每次房颤发作的时间（min）明显短于吲达帕胺组（146.8±39.4）min∶（197.2±43.7）min,P〈0.05。结论：依那普利治疗房颤优于吲达帕胺,其可能机制为降低交感神经张力,改善心房重构。     

培哚普利、氨氯地平、替米沙坦对血压及臂踝脉搏波传导速度的影响

目的 比较培哚普利、氨氯地平、替米沙坦i种降压药在改善高血压患者动脉弹性功能方而的差异.方法 112例高血压患者被随机分成三个治疗组:培哚普利组38例、氨氯地平组37例、替米沙坦组37例,每组有34例纳入最终统计数据,在服药前和服药1、3个月后应用科林波形分析仪PWV/ABI型仪器测量患者的臂踝脉搏波传导速度(baPWV).结果 (1)降压治疗后所有三组的收缩压、舒张压、脉压均较治疗前明显降低(P<0.001);心率则未见明显变化.(2)baPWV在三组经降压治疗后均有所下降,治疗前培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1859±492)cm/s、(1780±335)cm/s、(1859±337)cm/s;治疗1个月后培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1757±508)cm/s、(1647±285)cm/s、(1632±261)cm/s;治疗3个月后培哚普利组、氨氯地平组、替米沙坦组baPWV分别为(1702±538)cm/s、(1559±288)cm/s、(1566±326)cm/s.治疗1个月后与治疗前比较P<0.001;治疗3个月后与治疗前比较P<0.001;治疗3个月后与治疗1个月后比较培哚普利组和替米沙坦组P<0.01,氨氯地平组P<0.001.(3)降压治疗1个月后三组的baPWV均数差值变化及降压治疗3个月后三组的baPWV均数差值变化均为替米沙坦组最大[分别为(227±195)cm/s、(293±243)cm/s],在三组间比较差异有统计学意义(降压治疗1个月后P<0.01,降压治疗3个月后P<0.05).降压治疗3个月后与降压治疗1个月后比三组baPWV均有进一步的下降(P<0.01).结论 (1)本研究结果提示应用培哚普利、氨氯地平、替米沙坦降压均能改善高血压患者动脉弹性功能.(2)降压治疗1个月及3个月时,替米沙坦改善动脉弹性的作用最为明显.(3)血压降至正常并平稳后继续应用培哚普利、氨氯地平、替米沙坦降压治疗对于动脉弹性仍然存在持续的改善作用.     

Effects of short-term propylthiouracil treatment on p wave duration and p wave dispersion in patients with overt hypertyroidism.

BACKGROUND: P-wave duration is defined as the time measured from the onset to the offset of the P-wave in surface electrocardiogram (ECG). Prolonged P wave duration and increased P wave dispersion (PWD) have been reported to carry an increased risk for atrial fibrillation. AIM: Our aim was to evaluate the role of hyperthyroidism on P wave duration and dispersion, to investigate the effect of anti-thyroid therapy on P wave duration and dispersion. MATERIAL AND METHODS: A total of 44 consecutive subjects (22 patients with newly diagnosed overt hyperthyroidism and 22 randomly selected euthyroid healthy subjects) were enrolled in the study. Transthoracic echocardiography, 12 lead surface ECG and thyroid hormone levels were studied at the time of enrollment, in the first and third months of the 6-8 mg/kg/day propylthiouracil therapy. Patients were followed-up for 3 months. RESULTS: Patient and control groups were consisted of age and sex matched subjects. Baseline left atrial diameter was similar between the patient and control groups (3.4+/-0.3 cm and 3.4+/-0.3 cm respectively, p=0.813). The maximum P-wave duration (P maximum) was 113.1+/-6.6 and 105.7+/-4.1 ms in patient and control groups (p=0.001). PWD was 31.5+/-9.5 and 25.2+/-5.9 ms in patient and control groups respectively (p=0.015). At the third month of propylthiouracil treatment P maximum and PWD were decreased in the patient group at statistically significant level and returned back in normal limits (p<0.001 and p=0.001). CONCLUSION: P wave duration and PWD are found prolonged in hyperthyroid patients and propylthiouracil treatment decreased them effectively. This mechanism may establish how the anti-thyroid treatment may prevent the development of atrial fibrillation in hyperthyroid patients.