阿托伐他汀联合胺碘酮治疗原发性高血压伴阵发性房颤的研究(1)
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【摘要】 目的 探讨阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效及对左心房内径、C反应蛋白(CRP)的影响。方法 入选原发性高血压伴阵发性心房颤动患者80例,随机分成两组:对照组40例;阿托伐他汀组40例。均服药1年。观察两组治疗前后疗效及左心房内径、C反应蛋白的变化。结果 ①两组治疗后,对照组有效率38.4%,阿托伐他汀组有效率62.5%( χ2=4.56P<0.05);②两组治疗后比较,阿托伐他汀组左心房内径增大程度低于对照组(P<0.05),血CRP浓度比对照组降低明显(P<0.05)。结论 阿托伐他汀能通过抗炎、抑制左心房重构作用预防阵发性心房颤动复发。
【关键词】 阿托伐他汀;胺碘酮;原发性高血压;阵发性房颤;左房内径;C反应蛋白
The study of treatment of atorvastatin on hypertension with paroxysmal atrial fibrillation
XIONG Pan,ZHOU Li,HOU Yu-juan.The second people’s hospital of Liaocheng affiliated Taishan medical college,Shandong,Liaocheng 252600,China
【Abstract】 Objective To study the efficacy ofatorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 80 cases of hypertension with paroxysmal atrial fibrillation patients were selected randomly,which were divided into control group(40 cases) and atorvastatin group (40 Cases).And the two groups take medicine for 1 year. Compared with the efficacy,LAD and CPR before and after the treatment between 2 groups. Results ①After the treatment of the two groups,the efficient of control group was38.4%,and atorvastatin group was 62.5%( χ2=4.56P<0.05).②Compard between 2 groups after treatment,LAD of the the atorvastatin groupwas significantly smaller than control group (P<0.05),CRP of the atorvastatin group was significantly lower than that of the contral group (P<0.05). Conclusion The treatment with atorvastatin could prevent recurrence of paroxysmal atrial fibrillation through anti-inflammatory and inhibiting the remodeling of left atrial.
【Key words】 Atorvastatin;Amiodarone;Hypertension;Paroxysmal atrial fibrillation;Left atrial diameter;C-reactive protein
阵发性房颤是原发性高血压患者常见的一种心律失常。它可严重影响到患者的心脏储备功能,使患者的生活质量下降,而且能引起栓塞并发症,因此,在积极控制血压的同时,应注意预防房颤发作。近年来有研究表明[1-2],炎性反应是阵发性房颤的致病性因素,心房电重构和结构重构是房颤促发和维持的主要机制。C-反应蛋白(CRP)是一种重要的炎性反应标志物。有研究发现[3],阵发性房颤患者血清CRP水平高于正常人。因此,抑制左房重构及降低CRP的药物有预防及治疗房颤的作用。胺碘酮目前是最常用的预防房颤复发药物,但其有效率仅达40%～60%。本研究用阿托伐他汀联合胺碘酮预防房颤复发,在于观察阿托伐他汀对原发性高血压伴阵发性房颤患者预防房颤复发及对左房内径、CRP的影响。
1 资料与方法
1.1 一般资料 入选患者为2005年6月至2007年12月在本院心内科门诊就诊及住院的原发性高血压伴阵发性房颤患者80例。入选对象均为症状性房颤,未服用过胺碘酮预防房颤,年发作次数>5次,停服降脂药、抗心律失常药物至少2周,降压药物换用钙离子拮抗剂和/或利尿剂。阵发性房颤的诊断标准为房颤反复发作,每次发作时间短于或等于7 d[4] ......
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