左旋氨氯地平对阵发性房颤并高血压患者左心结构及房颤的影响

目的观察左旋氨氯地平对阵发性房颤并高血压患者左房内径（LAD）、左室舒张末内径（LVEDD）、左室射血分数（LVEF）、房颤发作情况的影响。方法将阵发性房颤并高血压患者100例随机分为治疗组（n=50）和对照组（n=50）。降压药物治疗组给予左旋氨氯地平,对照组给予坎地沙坦,随访1年,观察治疗前后LAD、LVEDD、LVEF、房颤发作情况。结果至随访结束,在长期应用胺碘酮的患者中,对照组房颤复发17例,占81.0%,治疗组房颤复发22例,占95.7%,两组之间没有差别（χ2=1.122,P〉0.05）。未长期应用胺碘酮的患者,对照组、治疗组在7～12个月时房颤发作次数均较治疗前减少（t=2.823,P〈0.01;t=2.655,P〈0.05）,两组之间没有差异（t=0.594,P〉0.05）。与治疗前比较,对照组、治疗组的LAD、LVEDD均降低、LVEF增加（t=2.421～3.814,P〈0.05）,治疗后两组之间的LAD、LVEDD、LVEF比较,差别无统计学意义（F=0.029～3.644,P〉0.05）。结论左旋氨氯地平和坎地沙坦均可减少阵发性房颤并高血压患者房颤的复发,降低LAD、LVEDD,升高LVEF,两者之间没有差异。

Effects of levamlodipine on atrial fibrillation recurrence and left cardiac structure in paroxysmal atrial fibrillation patients with hypertension

Objective To observe the effects of levamlodipine on left atrial dimension（LAD）,left ventricular end-diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF） and atrial fibrillation recurrence in paroxysmal atrial fibrillation patients with hypertension.Methods 100 patients of paroxysmal atrial fibrillation with hypertension were divided randomly into control group（n=50） and treatment group（n=50） for a 1-year follow-up.Control group were given candesartan for hypertension,treatment group were given Levamlodipine.ACEI,other CCBs and ARBs were prohibited in all patients.Atrial fibrillation episodes,LAD,LVEDD and LVEF were observed during the follow-up.Results In the patients used amiodarone,17 cases recurred atrial fibrillation in the control group during the follow-up,accounting for 81.0%,and 22 cases recurred atrial fibrillation in the treatment group,accounting for 95.7%.There was no difference between the two groups（χ2=1.122,P0.05）.In the patients without amiodarone application,frequency of atrial fibrillation recurrence in the 7~12 month decreased both in the control group and in the treatment group compared with treatment before（t=2.823,P0.01;t=2.655,P0.05）.There were no differences of frequency in the 7~12 month between the control group and the treatment group（t=0.594,P0.05）.After 1 year treatment,LAD,LVEDD decreased and LVEF increased both in the control group and the treatment group（t=2.421~3.814,P0.05）.There were no differences of LAD,LVEDD and LVEF between the control group and the treatment group（F=0.029~3.644,P0.05）.Conclusion In patients with paroxysmal atrial fibrillation and hypertension,levamlodipine can reduce the atrial fibrillation recurrence,LAD,LVEDD and improve LVEF.Its effects on paroxysmal atrial fibrillation are similar to candesartan.