高血压合并心房颤动患者血浆内皮素的相关性探讨

目的观察高血压合并心房颤动（房颤）患者血浆内皮素的变化,比较阿司匹林和华法林抗栓治疗对心房颤动患者内皮素的影响,指导临床合理使用抗栓治疗。方法将2009～2010年某医院57例高血压合并心房颤动患者随机分为阿司匹林组（29例）和华法林组（28例）,另外选择30例健康人为对照组。测定3组血浆内皮素水平,并心脏超声下评价心脏结构和功能的各项指标。阿司匹林组和华法林组分别给予阿司匹林100mg/d和调整剂量华法林[国际标准化比值（2～3）]治疗并随访一年,采用放射免疫分析法（RIA法）测定内皮素（ET）,比较两组治疗前后的内皮素变化。结果阿司匹林组和华法林组均能有效降低血浆内皮素水平,差异无统计学意义（P〉0.05）,但治疗后华法林组的内皮素水平略低于阿司匹林组。结论阿司匹林和华法林均能不同程度地降低高血压合并心房颤动患者血浆内皮素水平,两者的治疗效果无显著差异,值得在临床上广泛使用。

Discussion on Correlation of Plasma Endothelin in Patients with Hypertension Combined with Atrial Fibrillation

Objective To observe the changes of plasma endothelin in patients with hypertension combined with atrial fibrillation（AF） ,compare the effects of aspirin and warfarin antithrombotic therapy on endothelin in patients with atrial fibrillation,guide rational use of antithrombotic therapy. Methods From 2009 to 2010 in a hospital 57 patients with hypertension combined with atrial fibrillation were randomly divided into the aspirin group（29 cases） and the warfarin group（28 cases） and another 30 healthy cases were selected as control group. Plasma endothelin levels in 3 groups were determined,the various indicators of cardiac structure and function under cardiac ultrasound were evaluated. The aspirin group and the warfarin group were given respectively aspirin 100 mg/d and adjusted dose warfarin [international normalized ratio（2 ～ 3） ] treatment and followed-up for one year,radioimmunoassay（RIA method） was used to determine the endothelin（ET） ,the changes of endothelin were compared before and after treatment. Results The aspirin group and the warfarin group could effectively decrease plasma endothelin levels,the difference was not statistically significant（P 0.05） ,but after treatment in warfarin group endothelin level was slightly lower than that in aspirin group. Conclusion Aspirin and warfarin can reduce in different degrees plasma endothelin levels in patients with hypertension combined with atrial fibrillation,there are no significant differences in treatment effects,so they are worth being widely used in clinical practice.