【摘要】 目的　观察长效血管紧张素转换酶抑制剂 (ACEI)培哚普利对高血压合并心房颤动 (AF)患者再次脑卒中的干预作用。方法　选取高血压合并AF、且在 3年内发作脑卒中的患者 35例 ,随机分为对照组与治疗组。对照组继续原来的降压治疗方案 ,治疗组在此基础上再加用培哚普利 2～ 4 (mg/d)。观察血压、脉压、动态血压变化以及再次脑卒中的发生率和死亡率。结果　降压治疗 5年后 ,两组患者血压均显著下降 ,(P <0 0 0 1)。但治疗组血压波动幅度、脉压均明显降低 (P小于 0 0 0 5～0 0 0 1) ,而对照组无明显变化 (P >0 0 5 )。治疗组与对照组再次脑卒中发生率分别为 33 33% (5 / 15 )和 70 % (14 / 2 0 ) ,(P <0 0 0 1) ,RR为 0 4 8;脑卒中死亡率分别为 13 33% (2 / 15 )和 4 5 % (9/ 2 0 ) ,(P <0 0 1) ,RR为 0 30。结论　长效ACEI培哚普利可使血压平稳下降 ,使高血压合并AF患者再次脑卒中的发生率和死亡率均明显下降更多还原

【Abstract】 Objective To investigate the effect of perindopril on prevention of the recurrence stroke in the hypertension patients with atrial fibrillation(AF) Methods Thirty five hypertension patients with AF having a history of stroke within the previous 3 years was randomly enrolled into control group(20 cases) and treatment group(15 cases) Anti hypertension therapy with the calcium antagonist, β blocker and diuretic was given to the control group In addition to the conventional anti hypertension therapy, perindopril 2～4(mg/d) was given to the treatment group The ambulatory blood pressure monitoring was carried out on all patients Patients were followed up for 5 years Results After treatment, the causal blood pressure was reduced obviously in two groups( P <0 001), day time and night time SBP and DBP, the pulse pressure(PP) in treatment group was reduced obviously ( P <0 005～0 001, respectively), while no significant change in SBP, DBP and PP was found in the control group( P >0 05) The rate of recurrent stroke and the mortality due to the stroke in the treatment group was obviously lower than that in the control group ( P <0 01, respectively), RR was 0 48, 0 30, respectively Conclusion Perindopril decreased the rate of recurrence stroke and the mortality due to the stroke in the hypertension patients with AF更多还原