中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2009年
13期
24-27
,共4页
心房颤动%胺碘酮%缬沙坦%普伐他汀%慢性心功能不全
心房顫動%胺碘酮%纈沙坦%普伐他汀%慢性心功能不全
심방전동%알전동%힐사탄%보벌타정%만성심공능불전
Atrialfibrillation%Amiodarone%Valsartan%Pravastatin%Chronie congestive heart failure
目的 探讨他汀类药物及血管紧张素受体拮抗剂对慢性心功能不全患者阵发性心房颤动的影响.方法 145例伴有阵发性心房颤动的慢性心功能不全患者随机分为四组:胺碘酮组(Ⅰ组)、胺碘酮+缬沙坦组(Ⅱ组)、胺碘酮+普伐他汀组(Ⅲ组)、胺碘酮+缬沙坦+普伐他汀组(Ⅳ组),治疗随访2年,比较四组治疗前后左心房内径、C反应蛋白(CRP)水平变化及窦性心律维持率.结果 治疗后,Ⅰ、Ⅱ、Ⅲ、Ⅳ组的左心房内径分别为(44.1±2.1)、(41.7±2.8)、(44.4±3.1)、(40.1±2.5)mm.Ⅰ组和Ⅲ组左心房内径均大于Ⅱ组和Ⅳ组(P<0.05),而Ⅰ组和Ⅲ组,Ⅱ组和Ⅳ组比较差异无统计学意义;Ⅰ、Ⅱ、Ⅲ、Ⅳ组的CRP水平分别为(4.56 ±0.24)、(4.47±0.45)、(2.87±0.53)、(2.54 ±0.42)mg/L Ⅰ组和Ⅱ组CRP水平高于Ⅲ组和Ⅳ组(P<0.05),I组和Ⅱ组、Ⅲ组和Ⅳ组比较差异无统计学意义;Ⅰ、Ⅱ、Ⅲ、Ⅳ组的窦性心律维持率分别为57.9%、79.4%、77.1%、85.3%,Ⅰ组窦性心律维持率低于Ⅱ、Ⅲ和Ⅳ组(P<0.05).结论 缬沙坦和普伐他汀联合应用能减少慢性心力衰竭患者阵发性心房颤动的复发.缬沙坦能抑制左心房的扩大.而普伐他汀能有效降低血中CRP的水平.
目的 探討他汀類藥物及血管緊張素受體拮抗劑對慢性心功能不全患者陣髮性心房顫動的影響.方法 145例伴有陣髮性心房顫動的慢性心功能不全患者隨機分為四組:胺碘酮組(Ⅰ組)、胺碘酮+纈沙坦組(Ⅱ組)、胺碘酮+普伐他汀組(Ⅲ組)、胺碘酮+纈沙坦+普伐他汀組(Ⅳ組),治療隨訪2年,比較四組治療前後左心房內徑、C反應蛋白(CRP)水平變化及竇性心律維持率.結果 治療後,Ⅰ、Ⅱ、Ⅲ、Ⅳ組的左心房內徑分彆為(44.1±2.1)、(41.7±2.8)、(44.4±3.1)、(40.1±2.5)mm.Ⅰ組和Ⅲ組左心房內徑均大于Ⅱ組和Ⅳ組(P<0.05),而Ⅰ組和Ⅲ組,Ⅱ組和Ⅳ組比較差異無統計學意義;Ⅰ、Ⅱ、Ⅲ、Ⅳ組的CRP水平分彆為(4.56 ±0.24)、(4.47±0.45)、(2.87±0.53)、(2.54 ±0.42)mg/L Ⅰ組和Ⅱ組CRP水平高于Ⅲ組和Ⅳ組(P<0.05),I組和Ⅱ組、Ⅲ組和Ⅳ組比較差異無統計學意義;Ⅰ、Ⅱ、Ⅲ、Ⅳ組的竇性心律維持率分彆為57.9%、79.4%、77.1%、85.3%,Ⅰ組竇性心律維持率低于Ⅱ、Ⅲ和Ⅳ組(P<0.05).結論 纈沙坦和普伐他汀聯閤應用能減少慢性心力衰竭患者陣髮性心房顫動的複髮.纈沙坦能抑製左心房的擴大.而普伐他汀能有效降低血中CRP的水平.
목적 탐토타정류약물급혈관긴장소수체길항제대만성심공능불전환자진발성심방전동적영향.방법 145례반유진발성심방전동적만성심공능불전환자수궤분위사조:알전동조(Ⅰ조)、알전동+힐사탄조(Ⅱ조)、알전동+보벌타정조(Ⅲ조)、알전동+힐사탄+보벌타정조(Ⅳ조),치료수방2년,비교사조치료전후좌심방내경、C반응단백(CRP)수평변화급두성심률유지솔.결과 치료후,Ⅰ、Ⅱ、Ⅲ、Ⅳ조적좌심방내경분별위(44.1±2.1)、(41.7±2.8)、(44.4±3.1)、(40.1±2.5)mm.Ⅰ조화Ⅲ조좌심방내경균대우Ⅱ조화Ⅳ조(P<0.05),이Ⅰ조화Ⅲ조,Ⅱ조화Ⅳ조비교차이무통계학의의;Ⅰ、Ⅱ、Ⅲ、Ⅳ조적CRP수평분별위(4.56 ±0.24)、(4.47±0.45)、(2.87±0.53)、(2.54 ±0.42)mg/L Ⅰ조화Ⅱ조CRP수평고우Ⅲ조화Ⅳ조(P<0.05),I조화Ⅱ조、Ⅲ조화Ⅳ조비교차이무통계학의의;Ⅰ、Ⅱ、Ⅲ、Ⅳ조적두성심률유지솔분별위57.9%、79.4%、77.1%、85.3%,Ⅰ조두성심률유지솔저우Ⅱ、Ⅲ화Ⅳ조(P<0.05).결론 힐사탄화보벌타정연합응용능감소만성심력쇠갈환자진발성심방전동적복발.힐사탄능억제좌심방적확대.이보벌타정능유효강저혈중CRP적수평.
Objective To investigate the effect of statins and angiotensin receptor blocker (ARB) on paroxysmal atrial fibrillation in patients with chronic congestive heart failure. Methods All of 145 patients with chronic congestive heart failure and paroxysmal atrial fibrillation were randomly divided into four groups, Ⅰ group (treated with amiodarone ), Ⅱ group( treated with amiodarone and valsartan), Ⅲ group( treated with amiodarone and pravastatin)and Ⅳ group (treated with amiodarone,valsattan and pravastatin). After 2- year follow-up, observed the changes of left atrium diameter (LAD), C-reactive protein (CRP) and maintenance rate of sinus rhythm before and after treatment. Results After treatment, the data of LAD of the four groups were (44.1 ± 2.1 ), (41.7 ± 2.8), (44.4 ± 3.1 ), (40.1 ± 2.5) mm respectively. The LAD data of beth Ⅰ group and Ⅲ group were significantly higher than those of Ⅱ group and Ⅳ group (P < 0.05), but there was no significant difference either between Ⅰ group and Ⅲ group, or between Ⅱ group and Ⅳ group. The levels of CRP of the four groups were (4.56 ± 0.24), (4.47 ± 0.45 ), (2.87 ± 0.53 ), (2.54 ± 0.42) mg/Lrespectively, and the levels of CRP of Ⅰ group and Ⅱ group were obviously higher than those of Ⅲ group and Ⅳ group(P< 0.05 ), but there was no significant difference either between Ⅰ group and Ⅱ group,or between group and Ⅳ group. Maintenance rate of sinus rhythm of the four groups was 57.9%,79.4%,77.1%,85.3% respectively,the maintenance rate of sinus rhythm of Ⅰ group was significantly lower than that of Ⅱ,Ⅲ and Ⅳ group (P<0.05). Conclusions Va]asrtan and pravastatin may reduce recurrence of paroxysmal atrial fibri]lation in patients with chronic congestive heart failure. Valsartan may inhibit dilatation of left atrium, and pravastatin may decrease the level of CRP in blood.
