厄贝沙坦治疗老年高血压病合并阵发性心房颤动的疗效观察

目的探讨厄贝沙坦治疗老年高血压病合并阵发性心房颤动的临床疗效。方法选择2010年7月-2012年8月收治的60岁以上的门诊或住院高血压病合并阵发性心房颤动患者126例，随机分为对照组和治疗组，对照组给予苯磺酸氨氯地平片，治疗组给予厄贝沙坦片，两组均视血压情况酌情加用利尿剂，随访12个月，比较两组对老年高血压控制情况，心房颤动的复发次数、复发持续时间及左心房内径。结果治疗后两组血压均较治疗前明显降低，两组治疗后降压疗效差异无统计学意义（P〉0．05），治疗组心房颤动复发次数明显低于对照组（5．28±1．14）、（9．24±1．34）次，P〈0．01]；治疗组发作持续时间短于对照组（14.3±4．8）、（21．34-4．9）h、P〈0．01]；治疗组左心房内径比治疗前明显缩小，对照组无明显变化，两组比较差异有统计学意义（P〈0．01）。结论厄贝沙坦治疗老年高血压病合并阵发性心房颤动患者能有效降低血压，并减少心房颤动复发和心房颤动的持续时间，长期应用可抑制左心房扩大。

Clinical Effect of Irbesartan on Patients with Senile Hypertension Complicated with Paroxysmal Atrial Fibrillation

Objective To explore the effect of irbesartan on patients with senile hypertension complicated with paroxysmal atrial fibrillation. Methods A total of 126 inpatients and outpatients over 60 years of age with senile hypertension complicated with paroxysmal atrial fibrillation treated in our hospital from July 2010 to August 2012 were randomized into the study group （n=63, treated with irbesartan） and the control group （n=63, treated with amlodipine besylate）. Diuretics was added according to blood pressure of the patients. All the patients were followed up for 12 months. Blood pressure control situation, atrial fibrillation recurrence frequency and duration time, alteration of left atrial inner diameter were compared between the two groups. Results The level of blood pressure in both groups after treatment was significantly decreased compared with baseline, and there was no statistically significant difference in the decrease of blood pressure after treatment between the two groups （P 〉 0.05）. Atrial fibrillation recurrence frequency in the study group was （5.28 ± 1.14） times, which was significantly lower than that in the control group （9.24 ± 1.34） times] （P 〈 0.01）. The paroxysmal atrial fibrillation duration time in the study group was （14.3±4.8） hours, which was significantly lower than that in the control group （21.3 ± 4.9） hours] （P 〈 0.01）. After treatment, the left atrial inner diameter in the study group was significantly diminished compared with that before treatment （P 〈 0.01）. Conclusion For patients with senile hypertension complicated with paroxysmal atrial fibrillation, irbesartan is effective to control blood pressure, decrease atrial fibrillation recurrence frequency and duration, and inhibit left atrioventricular remodeling.