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目的探讨培哚普利联用胺碘酮对阵发性心房颤动(PAF)患者血浆心钠素(ANP)、N端脑钠素前体(NT-ProBNP)和超敏C反应蛋白(hs-CRP)的影响。方法选择PAF患者109例和正常对照者50例,将PAF患者随机分成两组,小剂量胺碘酮治疗(R1组)54例,小剂量胺碘酮及培哚普利联合治疗组(R2组)55例。分别用放射免疫法、电化学发光免疫法、免疫比浊法测定治疗前,治疗6个月及12个月后血浆ANP、NT-ProBNP和hs-CRP水平;经胸超声检查左房内径变化。结果 (1)PAF患者治疗前血浆ANP、NT-ProBNP水平均明显高于对照组,治疗后下降;(2)治疗后R2组血浆ANP、NT-ProBNP水平低于R1组(P<0.05);(3)治疗12个月后,R2组的左房内径小于Rl组(P<0.05);(4)R2组的窦性心律维持率高于Rl组(27.5%vs.19.3%)(P<0.05)。结论培哚普利联用胺碘酮较单用胺碘酮可明显降低PAF患者血浆ANP、NT-ProBNP水平,延缓左房内径扩大,减少房颤复发。
Objective To investigate the effects of perindopril and amiodarone on plasma atrial natriuretic peptide (ANP), NT-ProBNP and hs-CRP in patients with paroxysmal atrial fibrillation (PAF) )Impact. Methods A total of 109 patients with PAF and 50 normal controls were enrolled. Patients with PAF were randomly divided into two groups: 54 patients in low dose amiodarone group (R1 group), 50 patients in low dose amiodarone and perindopril combined group (R2 group) ) 55 cases. The levels of plasma ANP, NT-ProBNP and hs-CRP were measured by radioimmunoassay, electrochemiluminescence immunoassay and immunoturbidimetry before treatment, 6 months and 12 months after treatment respectively. Results (1) The plasma levels of ANP and NT-ProBNP in patients with PAF were significantly higher than those in the control group after treatment. (2) The levels of ANP and NT-ProBNP in R2 group were lower than those in R1 group after treatment (P <0.05) (3) After 12 months of treatment, the left atrial diameter of R2 group was smaller than that of Rl group (P <0.05); (4) The maintenance rate of sinus rhythm in R2 group was higher than that of Rl group (27.5% vs.19.3% 0.05). Conclusions Perindopril combined with amiodarone alone can significantly decrease plasma ANP and NT-ProBNP levels in PAF patients, prolong the diameter of left atrium and reduce the recurrence of atrial fibrillation.