【摘要】 目的研究缬沙坦对高血压病合并阵发性心房颤动(房颤)患者复律后阵发性房颤的再发率、持续性房颤的发生率以及高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、心房利钠肽(ANP)水平及左心房内径(LAD)的影响,探讨缬沙坦的抗房颤作用及机制。方法 90例高血压合并初发阵发性房颤患者,随机分成治疗组(n=45)和对照组(n=45)。在常规治疗的基础上,治疗组给予缬沙坦降压治疗,对照组给予硝苯地平控释片(拜新同)降压治疗,治疗周期1年。观察2组阵发性房颤复律后的再发率和持续性房颤的发生率,并检测2组治疗前后hs-CRP、IL-6、TNF-α、LAD及ANP的变化。结果治疗组房颤再次发作7例(15.6%),略低于对照组(14例,31.1%);治疗组转为持续性房颤2例(4.4%),略低于对照组(5例,11.1%),但差异均无统计学意义(P均>0.05)。治疗组治疗后hs-CRP、IL-6、TNF-α、LAD及ANP水平,均较对照组下降明显,差异有统计学意义(P均<0.05)。结论高血压病合并阵发性房颤患者用缬沙坦治疗,能够降低炎症因子及ANP水平、减小LAD,有降低阵发性房颤的再发率及持续性房颤发生率的趋势。更多还原

【Abstract】 Objective To investigate the impact of valsartan on the recurrent rate of paroxysmal atrial fibrillation and the incidence of persistent atrial fibrillation after cardioversion of atrial fibrillation,and the serum levels of hypersensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6),tumor necrosis factor-alpha (TNF-α),atrial natriuretic peptide (ANP) and left atrial diameter (LAD) in patients with hypertension complicated paroxysmal atrial fibrillation,and explore the effects and mechanisms of anti-atrial fibrillation of valsartan.Methods Consecutive 90 patients with hypertension complicated incipient paroxysmal atrial fibrillation between October 2007 and October 2009 were recruited in this study.The patients were randomly divided into treatment group and control group (n=45 each).On top of conventional therapy,valsartan and nifedipine controlled release tablets were respectively used for antihypertensive therapy in treatment group and control group.Treatment period was one year.The recurrent rate of atrial fibrillation and incidence of persistent atrial fibrillation after cardioversion of incipient paroxysmal atrial fibrillation were observed,and the changes of hs-CRP,IL-6,TNF-α,ANP and LAD before and after treatment were determined.Results After treatment,compared with control group,the incidences of atrial fibrillation relapse and transformed as persistent atrial fibrillation in treatment group had declining tendency〔15.6% (7 /45) vs 31.1% (14 /45),4.4% (2/45) vs 11.1%(5/45) 〕,despite there was no significance,and the levels of hs-CRP,IL-6,TNF-α,ANP and LAD in treatment group were markedly lowered (all P < 0.05).Conclusions Valsartan could decrease the levels of inflammatory factors and ANP and reduce LAD,and it has tendency of declining recurrent rate of paroxysmal atrial fibrillation and incidence of persistent atrial fibrillation.更多还原