曲美他嗪与厄贝沙坦联用治疗高血压病伴阵发性房颤

目的探讨曲美他嗪联合厄贝沙坦治疗高血压病伴降发性房颤的疗效及对左房内径、C反应蛋白（CRP）的影响。方法入选高血压病伴阵发性房颤患者160例，随机分为单用胺碘酮组（Ⅰ组）、胺碘酮加厄贝沙坦组（Ⅱ组）、胺碘酮加曲美他嗪组（Ⅲ组）、胺碘酮加厄贝沙坦加曲美他嗪组（Ⅳ组），每组40例，均服药1年。观察4组治疗前后疗效及左房内径、C反应蛋白的变化。结果4组治疗后．有效率Ⅰ组为46．1％，Ⅱ组为65.0％，Ⅲ组为56．4%．Ⅳ组为74．3％，Ⅱ组、Ⅲ组、Ⅳ组与Ⅰ组比较，差异有统计学意义（P〈0．05或P〈0.01）；Ⅱ组与Ⅲ组比较、Ⅳ组与Ⅱ组、Ⅲ组比较．差异均有统计学意义（P〈0．01）。4组治疗前后比较，Ⅱ组、Ⅳ组左房内径减小，Ⅰ组、Ⅲ组左房内径增大，治疗后Ⅱ组、Ⅲ组、Ⅳ组与Ⅰ组比较，差异有统计学意义（P〈0．01），Ⅱ组、Ⅳ组与Ⅲ组比较、Ⅳ组与Ⅱ组比较，差异均有统计学意义（P〈0.05或P〈0.01）；治疗岳4组血CRP浓度均比治疗前减低。结论曲羡他嗪联合厄贝沙坦能通过抗炎、抑制左房重构作用预防阵发性房颤复发。

Effect of Trimetazidine Combined with Irbesartan on Hypertension with Paroxysmal Atrial Fibrillation Patients

Objective To investigate the effect of trimetazidine combined with irbesartan on left atrial diameter and C - reactive protein（CRP）in hypertension patients with paroxysmal atrial fibrillation（PAF）. Methods One hundred and sixty hypertension patients with PAF were selected and divided randomly into four groups： Ⅰ group treated with amiodarone, Ⅱ group treated with amiodarone and irbesartan, Ⅲ group treated with amiodarone and trimetazidine and Ⅳ group treated with amiodarone,irhesartan and trimetazidine for Ⅰ year. The efficacy and the changes of left atrial diameter and CRP were observed. Results The total effective rate were 46.1% ,65.0% ,56.4%and 74.3% in Ⅰ group, Ⅱ group, Ⅲ group and Ⅳgroup. The total effective rate in Ⅱ group, Ⅲ group and Ⅱ group was higher than that in I group（P〈0.05 or P〈0.01）o There was statistical significance in the total effective rate between Ⅱ group and Ⅲ group, Ⅳ group and Ⅱ group, Ⅱ group（P〈0. 05 or P〈0.01 ）. After treatment, left atrial diameter in Ⅱ group and Ⅳ group was decreased while that in Ⅰ group and Ⅲ group was increased. There was different between Ⅱ group, Ⅲ group, Ⅳ group and Ⅰ group （P〈0.01）. After treatment,the levei of CRP were decreased in 4 groups. Conclusion Trimetazidine combined with irhesartan could prevent recurrence of PAF through anti-inflammatory,inhibiting left atrial remodeling.