目的：评价胺碘酮联合培哚普利治疗阵发性房颤的临床疗效，指导在治疗阵发性房颤过程中选择合理的药物以减少阵发性房颤的发生，改善患者的预后。方法将57例阵发性房颤随机分为胺碘酮组（A组，n=28）和胺碘酮+培哚普利（B组，n=29）,胺碘酮组（A组）包括男16例，女12例，平均年龄58±5.5岁，胺碘酮组（A组）中原发性高血压8例，特发性房颤2例，冠心病7例，风心病5例；胺碘酮+培哚普利（B组）包括男19例，女10例，平均年龄59±6.1岁，胺碘酮+培哚普利（B组）中原发性高血压9例，特发性房颤2例，冠心病6例，风心病7例。胺碘酮组（A组）患者胺碘酮的服用方法为：0.2g,3次/天服药一周,后减至0.2g,2次/天,服药一周，然后0.2g，一次/天，长期维持；胺碘酮+培哚普利（B组）患者在胺碘酮组（A组）治疗用药的基础上加用培哚普利，服用方法为：2mg，一次/天,服药四天，如无低血压，第五天加量至4mg,,一次/天，治疗随访时间为24个月。计算两组治疗后3、6、9、12、18、24月的窦性心律的维持率和治疗前、治疗后6、12、18个月的左心房内径。结果两组治疗前和治疗后6、12个月左心房内径无差别，18个月后有显著差异（P<0.05）,治疗后3、6、9个月，A组窦性心律维持率均低于B组，但无显著差异，而治疗12个月后，两组间有显著性差异（P<0.05）,治疗结束时A组的窦性心律维持率为61.26%，B组的窦性心律维持率为83.45%。结论胺碘酮联合培哚普利治疗阵发性房颤在维持窦性心律及减少心房颤动发作次数的疗效均优于单用胺碘酮，并能延缓左心房扩大。“,”Objective To evaluate the clinical effects of amiodarone combined perindopril to treat paroxysmal atrial fibril ation. Methods 57 cases were randomly divided into treated by amiodarone group (group A, n=28) and treated by amiodarone combined perindopril group (group B, n=29), fol ow-up for 24 months. Group A including 16 males and 12 females, the average age is 58±5.5 years old, and there are 8 cases of essential hypertension,2 cases of idiopathic atrial fibril ation,7 cases of coronary heart disease and 5 cases of rheumatic heart disease. Group B including 19 males and 10 females, the average age is 59 ± 6.1 years old, and there are 9 cases of essential hypertension,2 cases of idiopathic atrial fibril ation,6 cases of coronary heart disease and 7 cases of rheumatic heart disease. The patients in group A took amiodarone for 0.2g, 3times/day for a week, then reduced to 0.2g, 2times/day for a week, then took 0.2g, once/day in a long time. Based on the treatment of group A, the patients in group B plus perindopril, they took it 2mg,once/day, after four days ,without hypotension, the fifth day plus the amount to 4mg,once/day. Calculate the maintenance rate of sinus rhythm of the two groups after 3th, 6th, 9th, 12th, 18th, 24th months. And calculate the left atrial diameter before and after the treatment at 6th, 12th and 18th months. Results The difference of LAD was not significant between the two groups at the 6th and 12th months after treatment. At the 18th months after treatment, LAD in group A was significant enlarged compared with that in group B(37. 51±1.39mm vs 36 .011±l. 37, p<0.05). The maintenance rate of sinus rhythm in group A was lower, but not significant than it in group B at the3th, 6th, 9thmonths .However, it had significant difference at 12th months(P<0.05), at the 24th months after treatment, the maintenance rate of sinus rhythm was 61.26% in group A and 83.45% in group B(p<0.025 for both). Conclusion The combination of amiodarone and perindopril is more effective than amiodarone alone for treat paroxysmal atrial fibril ation, maintain sinus rhythm, reduce the number of episodes of atrial fibril ation and it is useful for delay left atrial enlargement.