血浆肾素-血管紧张素-醛固酮水平对胺碘酮转复房颤患者窦性心律效果的影响

目的研究不同肾素、血管紧张素和醛固酮水平对胺碘酮转律效果的影响.方法对持续性心房颤动患者,在使用胺碘酮转律后,依转律效果分为转律成功组(n=17)和转律未成功组(n=19),比较两组患者血浆肾素、血管紧张素和醛固酮浓度的不同,进一步分析其浓度水平与左心房大小的相关性.结果转律成功组患者血浆肾素、血管紧张素和醛固酮水平显著高于转律未成功组(P＜0.01,P＜0.05,P＜0.05);血浆肾素、血管紧张素和醛固酮水平与左心房直径呈显著正相关(P＜0.01).结论肾素、血管紧张素和醛固酮系统的激活对心房颤动的发生、维持和终止起重要作用.加用血管紧张素转换酶抑制剂可能改善心房颤动的转律效果.

Effect of renin-angiotensin-aldosterone system on the results of oral amiodarone reversing the sinus rhythm of patients with persistent atrial fibrillation

Objective To probe the effect of different concentrations of renin,angiotensin and aldosterone on amiodarones reversing of sinus rhythm in patients with persistent atrial fibrillation.Methods According to the results of amiodarone reversing their sinus rhythm,36 patients with persistent atrial fibrillation were divided into two groups,successful group (n=17) and unsuccessful group (n=19).Serum concentrations of renin-angiotensin-aldosterone of the two groups were compared and their correlations with left atrium diameter were also studied.Results The concentrations of renin, angiotensin and aldosterone in successful group were significantly higher than those of unsuccessful group (P<0.001,P<0.05,and P<0.05 respectively).The concentrations of renin,angiotensin and aldosterone correlated significantly with the diameter of left atrium (P<0.01).Conclusion Our results indicate that renin-angiotensin-aldosterone system plays an important role in the initiation,maintenance and termination of atrial fibrillation.Our results also suggest that angiotensin-converting enzyme inhibitors might facilitate rebuilding of the sinus rhythm for patients with persistent atrial fibrillation.