培哚普利联用胺碘酮治疗阵发性心房颤动ANP、NT-proBNP和hs-CRP水平变化的影响

目的:探讨单用胺碘酮或联用培哚普利治疗阵发性心房颤动(Paroxysmal atrial fibrillation,PAF)患者对血浆心钠素(Atrial natriuretic peptide.ANP)、N端脑钠素前体(N-terminalpro-plasma brain natriuretic peptide,NT-ProBNP)和超敏C反应蛋白(High-sensitivity C-reactivepmtein,hs-CRP)的影响.方法:入选112例PAF患者和50例正常对照者,PAF患者被随机分成2组,组1接受小剂量胺碘酮治疗(Rl组);组2接受小剂量胺碘酮及培哚普利联合治疗(R2组).分别用放射免疫法、电化学发光免疫法、免疫比浊法测定治疗前,接受治疗6个月及12个月后血浆ANP、NT-ProBNP和hs-CRP水平;经胸超声检查治疗前,接受治疗6个月及12个月左房内径变化;随访终点为房颤复发.结果:(1)PAF组服药前血浆ANP、NT-ProBNP水平均明显高于对照组,服药后上述指标均显著下降.(2)服药后R1组的血浆ANP、NT-ProBNP水平分别显著高于R2组;同时房颤复发组(RE)的上述血浆指标也显著高于维持窦律组(sR).(3)治疗后12个月,R2组的左房内径显著小于Rl组(35.73mm ± 5.90mm vs 37.85mm±4.70mm,P=0.04).(4)Kaplan-Meier生存分析显示R2组的窦律维持率显著高于RI组(p=0.02,log-rank test).结论:培哚普利联用胺碘酮较单用胺碘酮可明显降低阵发性房颤患者血浆ANP、NT-ProBNP水平.延缓左房内径扩大,减少房颤复发.

The changes of ANP,NT-ProBNP and hs-CRP before and after amiodarone plus Perindopril for the prevention of atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation

Objective:To explore the influence oflow-dose amiodarone alone or combined with Perindopril treatment on plasma ANP,NT-ProBNP,and hs-CRP in patients with paroxysmal atrial fibrillation(PAF).Methods:112 patients with PAF and 50 health people as controls were enrolled in the study.Patients with PAF were randomly assigned to two treatment subgroups:Group 1(R1),receiving treatment of low-dose amiodarone alone,Group 2(R2),receiving treamtment of low-dose amiodarone plus Perindopril.Blood samples of baseline,6-mo...