阻断肾素-血管紧张素系统对高血压患者心房颤动发生危险的影响

研究阻断肾素-血管紧张素系统(RAS)对高血压患者心房颤动(AF)发生危险的影响。将高血压患者分为AF组(n=216)和非AF组(n=216),对性别、年龄、既往病史、过敏史、高血压病程、血压控制水平、超声心动图左房直径和左室厚度、服用抗高血压药物种类和持续时间进行回顾性调查。结果:两组性别、年龄、病程、血压控制水平、超声心动图左房直径和左室厚度的差异无显著性意义,服用利尿剂、钙离子拮抗剂、α受体阻滞剂和β受体阻滞剂的情况无明显差别(P均>0.05)。AF组服用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)者有61例(28.2%),非AF组服用ACEI/ARB者有87例(40.3%),两组相比差异具有统计学意义(P<0.01),服用ACEI/ARB的患者发生AF的危险降低(OR=0.58)。多因素分析表明只有ACEI/ARB对AF发生起作用。结论:阻断RAS可能对高血压患者AF的防治有益。

Effect of Blocking Renin- Angiotensin System on the Risk of Atrial Fibrillation in Essential Hypertension Patients

To study the effect of blocking renin-angiotensin system(RAS) on the risk of atrial fibrillation in essential hypertension patients,essential hypertension patients were divided into atrial fibrillation group(n=216) and no-atrial fibrillaton group (n=216), variables(including sex,age,course of hypertension, past history,history of allergy,level of blood pressure controlled,left atrial diameter and left ventricular thickness measured with ultrasonic echocardiogram, classification and duration of antihypertensive drugs taken) were retrospectively investigated. Results: The difference of sex, age, course of hypertension, level of blood pressure controlled, left atrial diameter and left ventricular thickness between two groups was not significant. The proportion of taking diuretics, calcium ion antagonists, α receptor blockers and β receptor blockers was not significant different(all P>0.05). Sixty-one patients taking ACEI/ARB in atrial fibrillation group (28.2%),and eighty-seven patients taking angiotensin converting enzyme inhibitor (ACEI)/angiotensinⅡ receptor bloker(ARB) in no- atrial fibrillation group(40.3%) showed significant difference(P<0.01). Risk of atrial fibrillation decreased in patients taking ACEI/ARB (OR=0.58). Conclusion:Blocking of RAS may be beneficial to prevention and cure of atrial fibrillation in essential hypertension patients.