缬沙坦治疗高血压病合并阵发性心房颤动的临床研究

目的:观察缬沙坦对高血压病合并阵发性房颤患者的临床疗效并初步探讨其中的机制。方法:84例高血压病合并阵发性房颤患者随机分入缬沙坦组和对照组。缬沙坦组患者每日口服缬沙坦50-100 mg,若血压控制不理想,视情况加用利尿剂;对照组患者服用利尿剂和/或氨氯地平控制血压。所有患者在随访期间记录房颤发作情况,进入研究后6,12,18,24月做超声心动图测量左房内径等指标。结果:缬沙坦组38人、对照组37人完成研究。对照组6-12月、12-18月房颤发作次数与治疗前比较无显著差异,18-24月,房颤发作次数较治疗前显著增加(P<0.05);缬沙坦组6-12月、12-18月时房颤发作次数与治疗前无显著差异,18-24月显著少于治疗前(P<0.05)。缬沙坦组和对照组比较,18-24月房颤发作次数显著减少(P<0.05),其余时段无显著差异。对照组6,12,18月时左心房内径与治疗前比较无显著差异;24月时显著大于治疗前,也显著大于缬沙坦组(P<0.05);缬沙坦组左心房内径在各观察时间均与治疗前无显著差异。结论:缬沙坦可以延缓高血压病合并阵发性房颤患者心房增大,减少房颤发作。

Clinical Research on Effects of Valsartan on Patients with Essential Hypertension Complicated with Paroxysmal Atrial Fibrillation

Objective: To study the effects of valsartan on patients with essential hypertension(EH) complicated with paroxysmal fibrillation(PAF) and its mechanism.Methods: Eighty-four patients with EH complicated with PAF were divided randomly into valsartan group and control group.The patients in valsartan group took valsartan 50-100 mg per day orally,and took diuretics if necessary.The patients in control group took duretics and/or amlodipine orally. All the patients were followed up to record the onset of AF,and in 6,12,18,24 months later,the inner diameter of left atrium were measured by echocardiogram.Results: Thirty-eight patients in valsartan group and 37 patients in controlled group finished the study.The onsets of AF in controlled group during 6-12 and 12-18 months were not significantly changed,while in 18-24 months were increased significantly compared with pre-treatment and valsartan group(P<0.05).In valsartan group,the onset of AF during 6-12 and 12-18 months were not significantly changed and increased during 18-24 months.The inner diameter of left atrium in controlly group at the 6th and 12th month were not significantly changed and at the 24th month was significantly enlarged(P<0.05).The inner diameters of left atrium in valsartan group were not changed after treatment.Conclusion: Valsartan can prevent the enlargement of atrium of patients with EH complicated with PAF,and reduce the onsets of AF.