不同剂量胺碘酮联合氯沙坦治疗阵发性房颤患者的临床研究

目的:通过探讨不同剂量胺碘酮联合氯沙坦治疗阵发性房颤(PAF)患者的临床疗效,为PAF的治疗提供参考。方法:选择2013年6月~2014年6月本院收治的PAF患者共84例,按照随机数字表法随机分为大剂量组和小剂量组,分别在治疗1、3、6、12个月后观察两组患者窦性心律维持效果、左心室功能和血清高敏C反应蛋白(Hs-CRP)水平。结果:治疗1个月后,两组患者窦性心律维持效果的总有效率分别为93.73%和90.00%,差异无统计学意义(x~2=2.235;P0.05)。治疗3、6和12个月后,小剂量组患者窦性心律维持有效率均高于大剂量组,差异有统计学意义(x~2=4.208、5.271、5.688;P0.05)。小剂量组患者最大P波时限(Pmax)、P波离散度(Pd)和左心房直径(LAD)值均显著低于大剂量组患者,差异有统计学意义(t=-6.071、-3.509、-3.998;P0.05);左心室射血分数(LVEF)值显著高于大剂量组患者,差异有统计学意义(t=3.935;P0.05)。治疗1、6和12个月后,小剂量组血清Hs-CRP水平均低于大剂量组,差异有统计学意义(t=-4.515、-10.431、-19.113;P0.05)。结论:小剂量胺碘酮联合氯沙坦能够有效提高阵发性房颤患者窦性心律维持效果,改善患者左心室功能,降低Hs-CRP水平,值得临床推广借鉴。

Clinical Research of Different Doses of Amiodarone Combined with Losartan in Treatment of Patients with Paroxysmal Atrial Fibrillation

Objective:To explore clinical efficacy of different doses of amiodarone combined with losartan in treatment of patients with paroxysmal atrial fibrillation(PAF), and provide reference for PAF treatment.Methods:84 cases of PAF patients in our hospital from June 2013 to June 2014 were selected and divided into large dose group and small dose group according to random number table method. Indexes of maintaining sinus rhythm, left ventricular function and serumhigh-sensitivity C-reactive protein (Hs-CRP) levels of patients in the two groups were observed.Results:The maintain sinus rhythmefficiency of two groups were 93.73%and 90.00%respectively after 1 month treatment, the difference was not statistically significant (x2=2.235;P>0.05). The maintain sinus rhythm efficiency in low-dose group was higher than the high-dose group after treatment of 3, 6 and 12 months, the differences were statistically significant(x2=4.208, 5.271, 5.688; P<0.05). The maximum P wave duration(Pmax), P wave dispersion(Pd) and left atrial diameter (LAD) values in low-dose group were significantly lower than those in high-dose group, the differences were statistically significant (t=-6.071, -3.509, -3.998; P<0. 05); The left ventricular ejection fraction (LVEF%) of patients in low-dose group was significantly higher than that of high-dose group, the difference was statistically significant (t=3.935; P<0.05). The serum Hs-CRP level of patients in low-dose group was lower than the high-dose group after treatment of 1, 6, 12 months, the differences were statistically significant(t=-4.515, -10.431, -19.113; P<0.05).Conclusion:The low doses of amiodarone combined with losartan is able to effectively improve the effect of maintaining sinus rhythm and left ventricular function, reduce the Hs-CRP level in patients with PAF, which is worthy of clinical reference.