坎地沙坦酯联合胺碘酮对老年人阵发性心房颤动窦性心律的维持作用

目的：探讨坎地沙坦酯联合胺碘酮对老年人阵发性心房颤动窦性心律的维持作用及安全性。方法：选择2005年1月至2008年6月我院老年病科和心内科83例非瓣膜病阵发性房颤老年患者（≥65岁）,随机分为对照组（41例）和试验组（42例）。对照组给予胺碘酮,试验组给予胺碘酮＋坎地沙坦酯,随访观察12个月。结果：治疗12个月后,试验组窦性心律的维持率显著高于对照组（81.0%对65.9%,P〈0.05）,左心房内径显著小于对照组（34.1±5.8）mm对（37.8±6.4）mm,P〈0.05]。两组均未发生严重不良反应。结论：坎地沙坦酯联合小剂量胺碘酮对老年人阵发性心房颤动维持窦性心律的疗效优于单用胺碘酮,可能与坎地沙坦酯抑制心房电及结构重构,从而抑制左心房扩大有关。

Effect of Candesartan combined with Amiodarone on paroxysmal atrial fibrillation in older patients

Objective：To evaluate the effect and safety of Candesartan combined with Amiodarone on paroxysmal atrial fibrillation in older patients.Methods：We enrolled 83 cases of older patients with non-valval paroxysmal atrial fibrillation from Jan.2005 to Jun.2008 in Laiwu Steel Group hospital.They were divided randomly into the control group（n=41）and the treatment group（n=42）.Amiodarone was given in the control group and Candesartan combined with Amiodarone was given in the treatment group.Twelve months were followed-up.Results：The rate of sinus rhythm maintain in the treatment group were higher than that of the control group（81.0%vs.65.9%,P0.05）.The left atrial dimension in the treatment group were less than that of the control group（34.1±5.8）mm vs.（37.8±6.4）mm,P0.05].No main adverse effect were found in the two groups.Conclusions：The effect of Candesartan combined with Amiodarone are better than Amiodarone alone on sinus rythym maintain in older patients with paroxysmal atrial fibrillation.The effect may be related to the reduction of atrial remodeling which reduce the left atrial expansion.