静脉滴注胺碘酮治疗急性心肌梗死伴发房颤的临床疗效

目的探讨静脉滴注胺碘酮治疗急性心肌梗死并新发房颤的临床疗效及其安全性。方法60例急性心肌梗死伴新发快速房颤,静脉应用胺碘酮,先静脉推注负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制、血压及Q-T间期变化情况及药物不良反应。结果60例患者用药后0．25、1、2、24h的心室率分别是（136．2±19．4）、（119．4±15．9）、（101．5±14．1）、（82．7±20．8）次·min-1,较用药前心室率（140．3±17．5）次·min-1明显下降（P〈0．01）;44例（占73．3％）转复窦性心律;血压、啦T间期在用药前后差异无统计学意义（P〉0．05）。本组患者中1例出现窦性心动过缓;1例出现长R-R间期,经停药后恢复正常;1例用药期间发生静脉炎。结论静脉滴注胺碘酮治疗急性心肌梗死并新发快速房颤是安全及有效的。     

胺碘酮治疗急性心肌梗死并心房颤动33例临床观察

目的 观察静脉应用胺碘酮治疗急性心肌梗死(AMI)并心房颤动(AF)的临床疗效及安全性.方法 对33例AMI并AF患者,先用胺碘酮静脉注射负荷量后,继以静脉滴注维持.观察房颤转复、血压、心室率以及不良反应.结果 AF转复率2h内为42.4%(14/33),24h内为66.7%(22/33),48h内为84.9%(28/33),72h内为87.9%(29/33).用药24h后心室率明显下降,与治疗前比较有显著性差异(P＜0.001).用药前后血压变化不明显(P＞0.05).2例用药后出现长R-R间期,2例出现窦性心动过缓,经停药或减量恢复.结论 静脉应用胺碘酮治疗AMI并AF安全、有效,值得临床推广应用.     

胺碘酮治疗急性心肌梗死并发房颤的临床疗效观察

目的探讨胺碘酮治疗急性心肌梗死（AMI）并发房颤的方法及疗效。方法将2008年5月至2011年5月入住我科的120例急性心肌梗死并发房颤患者随机地均分为对照组与观察组两组。对照组（n=60）采用0.4mg西地兰,将其溶入至10mL浓度分数为5%的葡萄糖溶液中,于5min之内静脉推注完毕;观察组（n=60）采用25-100mg的胺碘酮进行缓慢静脉推注,然后以0.5-1mg/min的速度进行持续静脉滴注,直至转为窦性心律。对两组患者心电功能及生存质量进行对比。结果①两组患者最后均转复为窦性心律,且经治疗后两组患者心室率较治疗前均具有显著的统计学差异（P〈0.01）,但是组间不存在统计学差异（P〉0.05）;②上述两组患者在房颤转复时间、药物用量、房颤复发率等方面均存在显著的统计学差异（P〈0.01）;③观察组治疗后的左室射血分数（LVEF%）、左室舒张期末内径（LVDd）、HR、室性期前收缩[M（QR）]以及房性期前收缩[（QR）]较对照组具有显著的统计学差异（P〈0.01）;④对照组出现不良反应（如恶心、呕吐、血压下降等）的比率（38.3%）要明显高于观察组（15.0%）,且二者具有显著的统计学差异（P〈0.01）。结论静脉推注胺碘酮治疗急性心肌梗死并发房颤的临床治疗疗效明显,房颤时间明显缩短,胺碘酮用量发生明显减少,且能够显著改善患者的心功能状态、心功能指标、稳定心律,在很大程度上提高患者的治疗后的生存质量,值得在临床治疗AMI并发房颤中加以推广并应用。     

胺碘酮治疗急性心肌梗死并心房颤动的疗效观察

目的观察静脉应用胺碘酮治疗急性心肌梗死(AMI)并心房颤动(AF)的疗效及安全性。方法对28例AMI并AF患者,先用胺碘酮静脉注射负荷量后,继以静脉滴注维持。结果AF转复率2h内为39.3%(11/28),24h内为64.3%(18/28),48h内为85.7%(24/28),72h内为92.9%(26/28)。用药24h后心率明显下降,与治疗前比较有显著性差异(P<0.01)。用药前后血压变化不明显(P>0.05)。结论静脉应用胺碘酮治疗AMI并AF是安全有效的。     

静脉应用胺碘酮治疗心房颤动复律的疗效观察

目的:观察静脉应用胺碘酮对心房颤动复律的临床疗效。方法:将172例心房颤动患者随机分为胺碘酮组和安慰剂组。胺碘酮组(n=87)静脉推注胺碘酮5mg·kg-1,再以胺碘酮10～20mg·kg-1·d-1加入0.9%氯化钠注射液中持续静脉滴注,维持直至恢复为窦性节律;安慰剂组(n=85)静脉推注和静脉滴注0.9%氯化钠注射液,并给予控制心室率治疗。观察2组复律成功率和复律时间。结果:胺碘酮组有74例(85.1%)恢复为窦性节律,安慰剂组有68例(80.0%)恢复为窦性节律,2组比较差异无统计学意义(P>0.05)。胺碘酮组心房颤动持续时间短于安慰剂组(P<0.01)。胺碘酮组1例患者出现窦性心动过缓,停药后恢复。结论:胺碘酮静脉应用不能提高复律率,但能缩短心房颤动持续时间。     

静脉应用胺碘酮治疗阵发性房颤的临床观察

目的观察静脉应用胺碘酮对阵发性心房颤动的疗效。方法 61例阵发性房颤的患者,首剂静脉注射150mg,10min内注入,继之以0.5mg/分维持静脉泵入,30min未转复为窦性心律且心室率仍快者,追加静脉注射150mg。结果 15例4小时内转复窦性心律,18例4～12小时后转复窦性心律,13例12～48小时后转复窦性心律。转复率为83.6%;用药期间,2例出现窦性心动过缓,无低血压、心衰加重、心绞痛加重及QT间期延长等不良反应。结论静脉应用胺碘酮治疗阵发性心房颤动安全有效。     

血管紧张素转换酶抑制剂协助胺碘酮转复持续性心房颤动患者窦性心律的临床研究

目的观察血管紧张素转换酶抑制剂(ACEI)能否改善胺碘酮对持续性心房颤动的转律效果.方法74例持续性心房颤动患者随机分为两组,即ACEI组和非ACEI组,口服胺碘酮0.6g/d,2周,观察转律成功率和转律成功所需的时间.结果ACEI组胺碘酮转律成功率67.6%(23/34),显著高于非ACEI组(42.5%,17/40)(P＜0.05);ACEI组转律所用平均时间为9.2 d,显著少于非ACEI组(11.53 d)(P＜0.01).结论对持续性心房颤动患者进行胺碘酮转律治疗时,加用ACEI可增加转律成功率,并缩短转律所需时间.     

胺碘酮治疗急性心肌梗死并发复杂快速室性心律失常疗效观察

目的 评价急性心肌梗死(AMI)伴复杂快速室性心律失常(CVT)患者静脉注射胺碘酮的疗效及安全性.方法 106例血流动力学稳定的AMI伴复杂快速室性心律失常患者随机分为治疗组(53例)和对照组(53例).在常规治疗基础上,治疗组53例均采取静脉注射胺碘酮治疗,当血流动力学不稳定时立即改用电转复,转复成功后用胺碘酮维持窦性心律(窦律);对照组53例均用利多卡因治疗,若无效中途改为胺碘酮,当血流动力学不稳定时立即用电转复,电转复用利多卡因维持窦律.比较两组患者的临床疗效、心功能及心律失常的变化.结果 治疗组患者AMI后心绞痛发生率、硝酸甘油消耗量均较对照组减少,治疗组左室射血分数、左室短轴缩短率、左室快速充盈期和左房收缩期左房室瓣血流速度(E/A)均较对照组高(均P<0.01),治疗组总有效率明显高于对照组(75.5%与62.3%,P<0.01),尤以室性心动过速的有效率高于对照组(86.7%与50.0%,P<0.01).结论 静脉注射胺碘酮治疗急性心肌梗死伴复杂快速室性心律失常,安全有效并能改善心功能.     

Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials.

STUDY OBJECTIVE: To evaluate efficacy and safety of intravenous amiodarone for conversion of recent-onset atrial fibrillation. DATA SOURCES: MEDLINE search of published, randomized, controlled trials assessing the efficacy and safety of intravenous amiodarone in recent-onset (< 7 days) atrial fibrillation, supplemented with searches of reference lists of identified articles and bibliographies of secondary and tertiary review articles. STUDY SELECTION: The identified trials were eligible for meta-analysis if they met the following criteria: patients had recent-onset atrial fibrillation; patients were randomized to intravenous amiodarone, placebo, or another antiarrhythmic agent; no other antiarrhythmic agent except digoxin was administered simultaneously with intravenous amiodarone or other active treatments; the number and percentage of conversions to sinus rhythm after treatment began were reported; and the number and type of adverse drug reactions occurring after treatment began were reported. RESULTS: Eighteen randomized controlled trials, including active control cohorts and placebo cohorts, met inclusion criteria. Atrial fibrillation was spontaneous in 13 trials, postoperative in 4, and combined spontaneous and postoperative in 1. A total of 550 patients received intravenous amiodarone, 451 received other antiarrhythmic therapy, and 202 received placebo. Unadjusted averages for cardioversion were as follows: intravenous amiodarone, 417 (76%) of 550 patients; other antiarrhythmics, 324 (72%) of 451 patients; and placebo, 121 (60%) of 202 patients. Pooled estimates of cardioversion for active cohort studies were 72.1% for intravenous amiodarone and 71.9% for other antiarrhythmics (p=0.84). Pooled estimates of cardioversion for placebo cohort studies were 82.4% for intravenous amiodarone and 59.7% for placebo (p=0.03). Unadjusted averages for adverse event rates were intravenous amiodarone, 94 (17%) of 550 patients; other antiarrhythmics, 63 (14%) of 451 patients; and placebo, 23 (11%) of 202 patients. Pooled estimates of adverse event rates for active cohort studies were 12.2% for intravenous amiodarone and 14.0% for other antiarrhythmics (p=0.64). Pooled estimates of adverse event rates for placebo cohort studies were 26.8% for intravenous amiodarone and 10.8% for placebo (p=0.02). The most common adverse drug reactions reported with intravenous amiodarone were infusion phlebitis, bradycardia, and hypotension. CONCLUSION: The efficacy and safety profile of intravenous amiodarone is similar to that of other antiarrhythmics for cardioversion of recent-onset atrial fibrillation. Intravenous amiodarone is significantly more effective than placebo but is associated with significantly higher frequency of adverse events, although most were not considered to be dose limiting.     

倍他乐克联合胺碘酮治疗快速房颤疗效观察

目的探讨倍他乐克联合胺碘酮治疗快速心房颤动（房颤）的临床效果。方法将快速房颤患者56例随机分为观察组和对照组,各28例。对照组给予地高辛治疗,观察组给予倍他乐克联合胺碘酮治疗。观察2组卧位心率、血压及复律时间,并比较2组疗效。结果观察组总有效率为96.43%高于对照组的71.43%,差异有统计学意义（P〈0.05）。观察组患者卧位心率、收缩压、舒张压及复律时间明显优于对照组,差异有统计学意义（P〈0.05）。2组均未见明显的药物不良反应。结论倍他乐克联合胺碘酮治疗快速房颤,复律成功率高,时间短,优于地高辛等常规药物治疗。     

缬沙坦和阿托伐他汀联合胺碘酮治疗阵发性心房颤动疗效观察

目的 评价缬沙坦和阿托托他汀联合胺碘酮治疗阵发性心房颤动的临床疗效.方法 120例阵发性心房颤动患者完全随机分为治疗组(68例)和对照组(52例),全部患者经过口服或静脉注射胺碘酮或电复律恢复窦性心律后,对照组给予胺碘酮口服,第1周600 mg/d,第2周减至400 mg/d,第3周减至200mg/d,并以200 mg/d剂量用药至满1年.治疗组加用缬沙坦80 mg/d,阿托伐他汀钙胶囊10mg/晚.观察2组患者治疗第3、6、9、12个月的窦性心律维持率.结果 治疗3个月,治疗组、对照组窦性心律维持率分别为91.2％ (62/68)、86.5％ (45/52),2组差异无统计学意义(P＞0.05);治疗6、9和12个月,治疗组和对照组窭性心律维持率分别为86.8％( 59/68)、85.3％ (58/68)、82.4％(56/68)和71.2％( 37/52)、65.4％( 34/52)、59.6％(31/52),差异有统计学意义(P＜0.05).结论 缬沙坦和阿托伐他汀联合胺碘酮治疗阵发性心房颤动疗效优于单用胺碘酮治疗.     

联合用药对阵发性心房颤动患者疗效观察

目的 观察联合应用小剂量胺碘酮、螺内酯与厄贝沙坦对非瓣膜病阵发性心房颤动患者窦性心律的维持,对左心房内径、脑钠肽以及安全性的影响.方法 将142例非瓣膜病阵发性心房颤动按就诊顺序随机分为胺碘酮组(n=47),胺碘酮加螺内酯组(n=47),胺碘酮、厄贝沙坦、螺内酯组(联合用药组,n=48),3组均服用胺碘酮,胺碘酮加螺内酯组在应用胺碘酮基础上加用螺内酯,联合用药组在应用胺碘酮、螺内酯基础上加用厄贝沙坦,观察3组治疗6、12、18个月后的左心房内径、脑钠肽变化以及治疗3、6、12、18、24个月后的窦性心律维持率和安全性.结果 治疗6个月后3组左心房内径、脑钠肽值差异无统计学意义,但12个月后胺碘酮加螺内酯组、联合用药组的左心房内径、脑钠肽值明显小于胺碘酮组(P＜0.05),联合用药组左心房内径、脑钠肽值明显小于胺碘酮加螺内酯组(P＜0.05);治疗3、6个月后胺碘酮组窦性心律维持率低于胺碘酮加螺内酯组、联合用药组,治疗6个月后胺碘酮组和联合用药组之间差异有统计学意义(P＜0.05),治疗12个月后胺碘酮加螺内酯组、联合用药组的窦性心律维持率明显大于胺碘酮组(P＜0.05),联合用药组窦性心律维持率明显大于胺碘酮加螺内酯组(P＜0.05).结论 胺碘酮、螺内酯联合治疗非瓣膜病阵发性心房颤动维持实性心律的疗效优于单用胺碘酮,并能延缓左心房的扩大和脑钠肽值的升高,在胺碘酮、螺内酯基础上加用厄贝沙坦则使上述疗效进一步加强.

Abstract：

Objective To observe the effect and safety of amiodarone, spironolactone and irbesartan on sinus rhythm, left atrial internal diameter and brain natruretic peptide(BNP) for patients with nonvalvular paroxysmal atrial fibrillation(AF). Methods One hundred and forty-two patients with nonvalvular paroxysmal atrial fibrillation were divided into amiodarone group(n=47), amiodarone plus spironolactone group (n = 47 ) and amiodarone spironolactone plus irbesartan group ( Combined treatment group, n = 48 ). Three groups were treated with amiodarone.Amiodarone plus spironolactone group was treated with spironolactone in addition. Combined treatment group was treated with irbesartan based on amiodarone and spironolactone. Left atrial internal diameter and BNP were observed after 6 months, 12 months, 18 months respectively and the rate of maintenance of sinus rhythm was observed after 3months, 6 months, 12 months, 18 months, 24 months respectively. The safety of drugs was observed during this study. Results After 6 months treatments, left atrial internal diameter and BNP of three groups was no difference but left atrial internal diameter and BNP of amiodarone plus spironolactone group and Combined treatment group was less than that of amiodarone group after 12 months ( P ＜ 0.05 ). left atrial internal diameter and BNP of combined treatment group was less than those of amiodarone plus spironolactone group after 12 months ( P ＜ 0.05 ). After 3and 6 months treatments, the rate of maintenance of sinus rhythm of amiodarone group was lower than that in amiodarone plus spironolactone group and combined treatment group, but there was no statistically significance difference between amiodarone group and amiodarone plus spironolactone group, amiodarone plus spironolactone group andCombined treatment group. The rate of maintenance of sinus rhythmia of amiodarone group was statistically lower than that in combined treatment group (P＜0.05). After 12 months, The rate of mainterance of sinus rhythmia of amiodarone plus spironolactone group and Combined treatment group was more than that of amiodarone group (P＜0.05 ), and that of group Ⅲ was more than that of amiodarone plus spironolactone group ( P ＜ 0.05 ). Conclusions Therapeutic results of mainterance of sinus rhythmia is better with amiodarone plus spironolactone than with amiodarone lonely, and treatment with amiodarone plus spironolactone can suspend the enlargement of left atrial. This influence will strengthen if treated with irbesartan based on amiodarone and spironolactone.     

雷米普利和替米沙坦与胺碘酮联用治疗阵发性心房颤动的临床观察

目的探讨雷米普利和替米沙坦与小剂量胺碘酮联用对心功能正常的阵发性心房颤动（房颤）维持窦性心律的长期疗效。方法将180例阵发性房颤患者完全随机分为胺碘酮组（A组,61例）、胺碘酮＋雷米普利组（B组,59例）、胺碘酮＋替米沙坦组（C组,60例）,随访2年,比较3组治疗后6、12、18、24个月的窦性心律维持率以及治疗前、后的左心房内径。结果治疗12个月后,A组左心房内径大于B、C组（P〈0．05）,A组窦性心律维持率明显低于B、C组（P〈0．05）。试验终点时,A组的窦性心律维持率为58．62％,B组为77．78％,C组为78．57％（P〈0．05）。结论胺碘酮分别与雷米普利和替米沙坦配伍治疗阵发性房颤维持窦性心律具有相同的疗效,但优于单用胺碘酮,并能抑制左心房的扩大。     

静脉胺碘酮转复阵发性房颤临床疗效观察

目的：观察应用静脉胺碘酮转复阵发性房颤的有效性及安全性。方法选择本科阵发性房颤38例,给予胺碘酮150 mg＋5％GS 20 ml于15 min内缓慢静脉推注,观察20 min,房颤未转复,继续给予胺碘酮1 mg/min持续泵入,6 h后减为0.5 mg/min维持72 h。结果38例复律成功32例,1/2 h内转复者5例,1/2 h～24 h内转复者14例,24 h～48 h转复者9例,48 h～72 h转复者4例,总成功率84.2％。未发现明显不良反应。结论静脉胺碘酮转复阵发性房颤具有较好的疗效和安全性,并且不良反应轻。     

重症患者阵发心房颤动伴快速心室率的治疗方法研究

目的:观察病因治疗能否使重症监护病房中阵发心房颤动(简称房颤)患者转复窦律;比较静脉注射毛花苷丙-胺碘酮序贯治疗与单独注射胺碘酮转复无心脏病基础的房颤效果。方法:42例发作阵发性房颤伴快速心室率的危重症患者进行病因治疗,对未纠律者随机分配至毛花苷丙-胺碘酮序贯治疗与单独胺碘酮治疗组。结果:病因治疗后23例患者转复窦律。余19例患者进行随机分组,2组胺碘酮用量差异无统计学意义(P=0.386),心率变化差异无统计学意义(P=0.974),复发率差异无统计学意义(P=0.85)。结论:病因治疗可转复危重症患者房颤心律。对病因治疗不能纠律者,直接静脉注射胺碘酮效果与毛花苷丙-胺碘酮序贯治疗相同。     

Dofetilide: a class III anti-arrhythmic drug for the treatment of atrial fibrillation

Dofetilide is a class III anti-arrhythmic drug that has been approved for the treatment of atrial fibrillation. Two clinical studies, which enrolled 996 patients, demonstrated pharmacological conversion to sinus rhythm to occur in 30% of patients. Following pharmacological or electrical conversion, median time to relapse exceeded one year. Two large clinical studies that enrolled 3028 patients have been performed in high-risk patients with severe heart failure and large myocardial infarctions. The outcomes of these studies were neutral with respect to survival and demonstrated the safety of dofetilide. After pharmacological or electrical conversion of atrial fibrillation to sinus rhythm in these studies, the probability of remaining in sinus rhythm during the following year was 75%. Dofetilide has a single significant side effect: risk of developing torsade de pointes ventricular tachycardia. Therefore, dosage must be carefully adjusted to the length of QTc interval, calculated creatinine clearance and the presence of heart failure or recent infarction. In addition, treatment must be initiated in hospital with three days of continuous telemetry. Dofetilide can be co-administered with digoxin and β-blockers. Other anti-arrhythmic drugs, as well as drugs that interfere with the renal elimination or the metabolism of dofetilide, must be avoided. Dofetilide is an option when persistent atrial fibrillation is a clinical problem. In the setting of severe heart failure and large myocardial infarctions, only amiodarone and dofetilide have proven safety and dofetilide is a strong candidate for first choice treatment when the aim is to achieve sinus rhythm.     

胺碘酮联合贝那普利治疗阵发性心房颤动疗效观察

目的观察胺碘酮联合贝那普利治疗阵发性心房颤动的临床疗效与安全性。方法80例阵发性心房颤动患者随机分成观察组40例和对照组40例,观察组采用胺碘酮联合贝那普利治疗,对照组仅用胺碘酮治疗,比较两组治疗后24h…136、12个月转复窦性心律情况及药物不良反应。结果观察组治疗后24h窦性心律转复率为20．0％（8／40）,对照组为15．O％（6／40）,两组差异无统计学意义（x2=0．346,P=0．556）;观察组治疗后1、3、6、12个月窦性心律转复率分别为57．5％（23／40）、67．5％（27／40）、62．5％（25／40）、57．5％（23／40）,对照组分别为32．5％（13／40）、40．0％（16／40）、27．5％（11／40）、30．0％（12／40）,两组差异均有统计学意义（x2=5．051、6．084、9．899、6．146,P=0．025、0．014、0．002、0．013）。观察组发生胃肠不适1例,对照组发生恶心呕吐3例,心动过缓4例,QT问期延长2例,观察组不良反应发生率低于对照组（x2=5．600,P=0．018）。结论胺碘酮联合贝那普利治疗阵发性心房颤动,效果优于单用胺碘酮,且能有效减少不良反应,值得临床重视。     

稳心颗粒联合胺碘酮对阵发性心房颤动患者P波离散度及C反应蛋白的影响

目的:探讨稳心颗粒对阵发性心房颤动患者P波离散度及C反应蛋白(CRP)的影响。方法:将80例阵发性心房颤动患者随机分成研究组(给予胺碘酮+稳心颗粒治疗)和对照组(给予胺碘酮治疗),每组各40例,随访1年。观察两组治疗前后P波离散度、CRP和窦性心律维持率的变化。结果:两组P波离散度和CRP较治疗前均有明显下降(P<0.05),组间比较差异亦有统计学意义(P<0.05);随访1年时,研究组窦性心律维持率明显高于对照组(P<0.05)。结论:胺碘酮联合稳心颗粒治疗阵发性房颤对降低P波离散度、CRP和房颤复发率有一定作用。     

Effect of digoxin on the extent of injury and the severity of arrhythmias during acute myocardial ischemia and infarction in the dog

Recently, this laboratory has demonstrated an enhanced susceptibility toward the development of lethal ventricular arrhythmias occurring in response to acute posterolateral ischemia in dogs with previous anterior myocardial infarction in the presence of therapeutic serum concentrations of digoxin. In the present study, acute posterolateral myocardial ischemia was produced in the absence of previous myocardial infarction in 15 digoxin-pretreated (1.19 +/- 0.21 ng/ml serum digoxin, 5-7 days pretreatment) and 11 vehicle-pretreated dogs. The incidences of sudden ventricular fibrillation and of 24 h arrhythmic mortality in response to posterolateral ischemia were 4/15 (27%) vs. 1/11 (9%) (p = 0.23) and 7/15 (47%) vs. 4/11 (36%) (p = 0.27) for digoxin- vs. vehicle-pretreated dogs, respectively. Ventricular ectopic activity at 24 and 48 h after the onset of posterolateral ischemia was reduced significantly by both intravenous lidocaine (1.0-5.0 mg/kg) and verapamil (50.0-500.0 micrograms/kg) in the vehicle-pretreated dogs, whereas neither antiarrhythmic agent significantly suppressed ventricular ectopy in the digoxin-pretreated dogs. The mean sizes for developing posterolateral myocardial infarctions (percentage of left ventricle) were greater for the digoxin-pretreatment group (31.9 +/- 2.8%) vs. vehicle-pretreatment group (14.8 +/- 2.0%, p less than 0.001). These findings suggest that uncomplicated acute myocardial ischemia in the presence of serum concentrations of digoxin that are considered clinically therapeutic may result in the development of larger areas of developing myocardial infarction and in the occurrence of ventricular arrhythmias that are less sensitive to suppression with conventional antiarrhythmic agents.     

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.