福辛普利治疗高血压病合并阵发性房颤的疗效

目的探讨福辛普利治疗高血压病合并阵发性房颤的临床疗效，并初步探讨其中的药理学机制。方法将90例高血压病合并阵发性房颤患者随机分成观察组（45例）和对照组（45例）。对照组予常规降压治疗，观察组在此基础上给予福辛普利治疗；在服药前、服药后6个月分别测定每组患者收缩压（SBP）、舒张压（DBP）、脑钠肽（BNP）、C-反应蛋白（CRP）、血管紧张素Ⅱ（AngⅡ），并观察服药6个月后房颤复发率，再分析房颤复发与BNP、CRP、AngⅡ、左心房内径（LAD）、P波离散度（Pd）的相关性。结果观察组患者服药前与服药后6个月相比较，SBP、DBP、BNP、CRP、AngⅡ、LAD和Pd明显降低（P〈0．01），对照组仅SBP、DBP明显降低（P〈0．01），其他指标与治疗前比较差异无统计学意义（P〉0．05）；治疗6个月后观察组房颤发作次数较对照组明显降低，Logistic回归分析结果表明，发现BNP、Pd、CRP、AngⅡ与房颤复发关系最密切，是房颤复发的独立危险因素。结论福辛普利治疗高血压病合并阵发性房颤患者，在明显降低血压的同时可明显减少房颤发作，BNP、Pd、CRP和AngⅡ对房颤的预测、治疗及预后评估提供了新的临床依据。

Effect of fosinopril in treating hypertension patients combined with paroxysmal atrial fibrillation

Objective To investigate the clinical effect and mechanism pharmacology of fosino- pril in treating hypertension patients combined with paroxysmal atrial fibrillation. Methods A total of 90 hypertension patients combined with paroxysmal atrial fibrillation were randomly divided into the observation group（ n = 45 ） and control group （n = 45 ）. The control group received the routine decompression therapy, while the observation group received the fosinopril therapy in addition. Patients in each group were obtained before and after taking medication six months of SBP, DBP, BNP, CRP, Ang Ⅱ , LAD and the Pd, and observe the recurrence rate of atrial fibrillation after six months medication therapy, then to analyse the correlation of that： BNP, CRP, Ang Ⅱ , LAD and Pd with the recurrence rate. Results The level of SBP, DBP, BNP, CRP, Ang Ⅱ , LAD and Pd in hyper- tension patients combined with paroxysmal atrial fibrillation after taking medication 6 months were significantly lower than pre - treatment （ P 〈 0.01 ） while only SBP and DBP were significantly reduce （P 〈0. 01 ） , the other indexs without statistical significance compared with pre - treatment（ P 〉 0.05 ）. The onsets of atrial fibrillation in the observation group compared with control group was significantly reduced. Mul-tiple logistic regression analysis revealed that BNP, Pd, CRP, AngⅡ were the important risk factors of the onsets of atrial fibrillation. Conclusions Fosinopril in treating atrial fibrillation patients with essential hypertension, which can significantly blood pressure, in the same time, can significantly reduce the onsets of atrial fibrillation. BNP, Pd, CRP and AngⅡ can provide a new clinical basis of the predic tion, treatment and prognosis of atrial fibrillation.