小剂量胺碘酮与氯沙坦联合治疗阵发性房颤复律后维持的观察

目的了解小剂量胺碘酮联合氯沙坦对阵发性房颤复律后窦性心律维持的影响。方法2004年1月至2008年12月,82例非瓣膜病阵发性房颤患者分为胺碘酮对照组（42例）和小剂量胺碘酮＋氯沙坦治疗组（40例）,观察患者治疗6个月和1年房颤复律维持情况,评价两组窦性心律维持效果。结果胺碘酮组房颤治疗6个月和1年时转复维持有效率分别为90.47%和71.42%;小剂量胺碘酮＋氯沙坦治疗组转复维持有效率为92.50%和87.5%,1年时两组结果差异有统计学意义（P＆lt;0.05）。治疗1年时患者左房内径分别为（37.5±1.7）mm和（34.8±1.9）mm（P＆lt;0.05）。结论小剂量胺碘酮＋氯沙坦对阵发性房颤的复律后窦性心率维持优于单用胺碘酮治疗,且副作用小,可能与氯沙坦抑制血管紧张素,降低心脏负荷,抑制心房电及结构重构有关。

Efficacy of losartan combined with small amount of amiodarone in the maintetnance of sinus rhythm with paroxysmal AF

Objective To investigate the efficacy of losartan combined with small amount of amiodarone in the maintetnance of sinus rhythm with paroxysmal AF. Methods From Juanary 2004 to December 2008, 82 consec- utive patients with paroxysmal AF were rondomly divided into two group： group A （ amiodarone, N =42） and group B （amiodarone plus losartan, N = 40）. The left atrial diameter was measured with transthoreic echocardiogram at before and after 6, 12 - months of treatment. Results The left atrial diameter in group A was significantly larger than that in group B in 12 months. The maintenance of sinus of rhythm in group B is much higher than that in group A （$7.5% vs 71.42% ,P 〈 0.05）. Conclusion The conbimation of small amount of amiodarune with losartan is more effictive that amiodarnce alone in the maintenee of sinus thythm.