老年高血压合并阵发性房颤应用替米沙坦治疗的效果分 析简

目的探讨替米沙坦治疗老年高血压合并阵发性房颤的效果及其对左房内径的影响。方法选择揭阳市人民医院2010年6月～2013年5月收治的老年高血压合并阵发性房颤患者76例，随机分为研究组和对照组，各38例，研究组给予替米沙坦治疗，对照组给予拉西地平治疗，两组均治疗1年，每月随访1次，观察患者血压、房颤、左房内径改善情况。结果两组治疗后收缩压、舒张压均较治疗前显著降低（P〈0．05），但组问比较差异无统计学意义（t=0．099、0．121、0．091、0．074，均P〉0．05）；治疗6个月研究组房颤持续时间明显少于对照组（t=4．754．P〈0．05），治疗12个月后研究组房颤发作次数和持续时间均较治疗前和对照组明显减少（t=5．526、7．459，均P〈0．05）；治疗6个月时两组左房内径均无明显变化，治疗12个月时研究组左房内径较对照组明显缩小（t=4．629，P〈0．05）。结论替米沙坦治疗老年高血压合并阵发性房颤可有效降低患者血压，长期用药（半年以上）可明显改善房颤发作次数及持续时间，有效改善左房重构，值得推广。

Curative effect of Telmisartan in the treatment of elderly hypertensive patients with paroxysmal atrial fibrillation

Objective To investigate the effect of Telmisartan in the treatment of elderly hypertensive patients with paroxysmal atrial fibrillation and influence on left atrial diameter. Methods 76 cases of elderly hypertensive patients with paroxysmal atrial fibrillation （AF） in Peoplels Hospital of Jieyang City from June 2010 to May 2013 were randomly divided into study group and control group, with 38 cases in each group, study group was given Telmisartan treatment, the control group was given Lacidipine treatment, patients were treated for one year, and followed up once a month, blood pressure, atrial fibrillation, left atrial diameter improvement situation of two groups were observed. Results After treatment, systolic blood pressure and diastolic blood pressure of two groups were all lower than those before treatment （P 〈 0.05）, but the differences between groups were not statistically significant （t = 0.099, 0.121, 0.091, 0.074, all P 〉 0.05）; after 6 months of treatment, AF duration of treatment group was significantly less than control group （t = 4.754, P 〈 0.05）, after 12 months of treatment, AF duration and frequency of study group were less than those of control group （t = 5.526, 7.459, all P 〈 0.05）; after 6 months of treatment, left atrial diameter of two groups were not significantly re- duced, but after 12 months of treatment, left atrial diameter of the study group was significantly shorter than control group （t -- 4.629, P 〈 0.05）. Conclusion Telmisartan in treatment of elderly hypertensive patients with paroxysmal atrial fibrillation can effectively reduce blood pressure, long-term medication （more than half a year） can significantly im- prove the atrial fibrillation frequency and duration, effectively improve the reconstruction of left atrium, it is worthy of promotion.