厄贝沙坦联合阿托伐他汀治疗高血压合并阵发性心房颤动的临床分析

目的:探讨厄贝沙坦联合阿托伐他汀治疗高血压合并阵发性心房颤动(房颤)的临床疗效.方法:282例合并阵发性房颤的高血压患者随机分为4组:胺碘酮加硝苯地平组(A组)、胺碘酮加硝苯地平加厄贝沙坦组(B组)、胺碘酮加硝苯地平加阿托伐他汀组(C组),胺碘酮加硝苯地平加厄贝沙坦组加阿托伐他汀(D组),治疗随访1年,比较4组治疗前后CRP、IL-6、肾素、血管紧张素Ⅱ(Ang Ⅱ)水平,左心房内径及窦性心律维持率的变化.结果:治疗前后CRP及IL-6水平,C、D组均显著低于A、B组(P<0.05),A、B两组间,C、D两组间比较差异无统计学意义(P>0.05);肾素、Ang Ⅱ水平及左心房内径B、D组均显著低于A、C组(P<0.05),A、C两组间,B、D两组间比较差异无统计学意义(P>0.05);窦性心律维持率B、C、D组均显著高于A组(P<0.05),B、C两组组间比较差异无统计学意义(P>0.05),但D组高于B、C组(P<0.05).结论:在降压达标的基础上,阿托伐他汀及厄贝沙坦均能减少高血压患者阵发性房颤的复发;阿托伐他汀能有效降低血中CRP、IL-6的水平;厄贝沙坦能降低血中肾素、Ang Ⅱ水平,长期应用可抑制左心房的扩大.

Clinical study of irbesartan and atorvastatin on paroxysmal atrial fibrillation of patients with essential hypertension

Objective:To explore the effect of Irbesartan and Atorvastatin on paroxysmal atrial fibrillation of patients with essential hypertension.Methods:Two hundred and eighty patients with essential hypertension and paroxysmal atrial fibrillation were randomly divided into four groups,group A(treated with amiodarone and nifedipine),group B(treated with amiodarone,nifedipine and irbesartan),group C(treated with amiodarone,nifedipine and atorvastatin) and group D(treated with amiodarone,nifedipine,irbesartan and atorvastatin).After 1 year follow-up,observe the change of C-reactive protein(CRP),interleukin-6(IL-6),rennin,angiotensin Ⅱ(Ang Ⅱ),left atrium diameter and maintenance rate of sinus rhythm after treatment 0,3,6,9,12 months.Results:After treatment,the level of CRP,IL-6 of group C and group D was obviously lower than that of group A,B(P<0.05),but there was no notably difference between group A and group B,and between group C and group D.The level of rennin,Ang Ⅱ and left atrium diameter of group B and group D was obviously lower than that in group A,C(P<0.05),and but there was no notably difference between group A and group C,and between group B and group D.Maintenance rate of sinus rhythm of group B,C,D was significantly higher than that in group A(P<0.05),and there was no notably difference between group B,C,D,but the rate of group D is a little higher than group B,C with significance.Conclusions:Atorvastatin and irbesartan may reduce recurrence of paroxysmal atrial fibrillation of patients with essential hypertension.Atorvastatin may lower the level of CRP and IL-6 in blood,Irbesartan may inhibit dilatation of left atrial,rennin and Ang Ⅱ in blood.