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目的:观察3种药物治疗高血压后心房纤颤(AF)的发生情况。方法:将211例高血压患者分为3组:氨氯地平组70例,培哚普利组71例,氯沙坦钾组70例,治疗时间均为24个月。将血压控制在正常水平时,观察治疗前、后左房内径和随访过程中的AF发生情况。结果:治疗24个月后,培哚普利组、氯沙坦钾组较氨氯地平组AF发生率低、左房内径缩小,差异有统计学意义(P<0.05);培哚普利组、氯沙坦钾组之间差异无统计学意义(P>0.05)。氨氯地平组有3例双下肢踝部水肿不能耐受退出,培哚普利组有4例顽固性干咳不能耐受退出,氯沙坦钾组无一例退出。结论:将高血压患者血压控制在正常水平时,培哚普利、氯沙坦钾能改善患者心房电重构和解剖重构,使AF发生率低、左房内径缩小。氯沙坦钾组无一例退出试验,耐受性更好。
Objective: To observe the occurrence of atrial fibrillation (AF) after 3 kinds of drugs in treating hypertension. Methods: 211 hypertensive patients were divided into three groups: amlodipine group 70 cases, perindopril group 71 cases, losartan potassium group 70 cases, the treatment time was 24 months. When the blood pressure was controlled at normal level, the left atrium diameter before and after treatment and the incidence of AF during follow-up were observed. Results: After 24 months of treatment, the incidence of AF in perindopril group and losartan potassium group was lower than that in amlodipine group, and the diameter of left atrium was reduced with a significant difference (P <0.05). Perindopril group , Losartan potassium group difference was not statistically significant (P> 0.05). Amlodipine group, 3 cases of lower extremity ankle edema can not tolerate withdrawal, perindopril group 4 cases of intractable dry cough can not tolerate withdrawal, losartan potassium group without any withdrawal. CONCLUSION: Perindopril and losartan potassium can improve the atrial electrical remodeling and anatomy and remodeling of patients with hypertension. The incidence of AF is low and the left atrial diameter is reduced. None of the losartan potassium groups quit the test and were better tolerated.