培垛普利和厄贝沙坦在胺碘酮治疗慢性心房颤动中的作用

目的观察培垛普利和厄贝沙坦分别与胺碘酮联合运用在持续性心房颤动复律中的作用。方法持续性心房颤动患者216例，按入院顺序随机分成A（胺碘酮组72例）、B（胺碘酮＋培垛普利组72例）、c（胺碘酮＋厄贝沙坦组72例）三组。A组抗凝3周后给予胺碘酮静脉450mg负荷，同时口服胺碘酮0．2gTid×7d，0．2gBid×7d，随后0．2gqd。B组开始抗凝3周时给予培垛普利4mgqd，C组开始抗凝3周时给予厄贝沙坦150mgqd，3周后加用胺碘酮复律（剂量和服法同A组）。4周后观察各组转复为窦性心律的例数和已复律者6个月时窦性心律维持情况。结果厄贝沙坦和培垛普利＋胺碘酮组较仅用胺碘酮组转复成功率（72．86％、70．42％比54．29％，P〈0．01）及中期（6个月）维持窦性的情况均优于单用胺碘酮组（90．00％、84．31％比68．42％，P〈0．05）。结论复律前短期服用厄贝沙坦或培垛普利均能提高胺碘酮对持续性房颤复律效果，中期使用厄贝沙坦和培垛普利能防止房颤的复发。

Effects of perindopril and irbesartan on chronic atrial fibrillation treating by amiodarone

Objective To evaluate the effects of perindopril and irbesartan combine with amiodarone respectively on cardioversion in continuous atrial fibrillation. Mehtods Two hunderd-sixteen patients were randomly divided into three groups according to the time of hospitalization： group A （amiodarone, n=72）, group B（amiodarone ＋perindopril, n=72）, group C （amiodarone＋ irbesartan, n=72）. After anticoagulating three weeks patients of group A were injected 450 mg amiodarone, simultaneously, 200 mg amiodarone were taken three times a day for a week, then 200 mg amiodarone were taken two times a day for a week, after then, 200 mg amiodarone were taken one time a day; continuously anticoagulating for three weeks; the patients of group B were taken oral perindopril 4 mg a day, similarly to group B, patients of group C were taken irbesartan 150 mg a day. After anticoagulating three weeks in group B and C, the amiodarone were administrated （the method and dose were same as group A）. The quantity of cardioversion after administrating with drug above mentioned, and the effect of maintaining sinus rhythm after cardioversion during six-months were observed. Results The rate of cardioversion （72.86% ,70.42% vs 54.29% , P〈0.01） and maintaining sinus rhythm in amiodarone combine irbesartan or perindopfil （90.00%, 84.31% vs 68.42%, P〈0.05） were higher than amiodarone alone. Conclusion Before eardioversion in continuous atrial fibrillation, taking irbesartan or perindopril for a short-time that may increasing the success rate of cardioversion, and in intermediate stage, taking irbesartan and perindopril can decreasing recurrence after cardioversion.