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目的:研究不同剂量胺碘酮联合氯沙坦治疗阵发性房颤患者复律后的窦性心律维持效果。方法:选取2013年1月到2014年1月我院收治的阵发性房颤患者130例,按照随机数字表法将患者分为A组和B组,每组65例,两组均给予氯沙坦治疗,A组给予胺碘酮600 mg/d,1-2周后改用200 mg/d维持1年;B组给予胺碘酮600 mg/d,1-2周后改用200 mg/d,1个月后改为100mg/d维持1年,比较两组治疗前后转复维持有效率、心率、血压、左房内径(LAD)、左房舒张末期容积(LAEDV)、左房收缩末期容积(LAESV)、左心房射血分数(LAEF)以及不良反应。结果:两组转复维持有效率比较差异无统计学意义(P>0.05);治疗后收缩压、舒张压、LAEDV和LAESV均优于治疗前(P<0.05),但治疗后两组组间心率、收缩压、舒张压、LAD、LAEDV、LAESV、LAEF比较差异无统计学意义(P>0.05);B组不良反应发生率显著低于A组,两组比较差异具有统计学意义(P>0.05)。结论:小剂量胺碘酮联合氯沙坦与大剂量胺碘酮联合氯沙坦治疗阵发性房颤转复效果相当,但是不良反应较少。
Objective: To study the effects of different doses of amiodarone combined with losartan on sinus rhythm maintenance after cardioversion in patients with paroxysmal atrial fibrillation. Methods: 130 patients with paroxysmal atrial fibrillation admitted to our hospital from January 2013 to January 2014 were selected and randomly divided into group A and group B (65 cases in each group) according to the random number table method. Both groups were given chlorine Losartan 600 mg / d in group A, 200 mg / d in 1 to 2 weeks and 1 year in group A. Amiodarone 600 mg / d in group B and 200 mg in week 1-2 / d, one month later changed to 100mg / d for 1 year, compared two groups before and after treatment to maintain the efficiency of recovery, heart rate, blood pressure, left atrium diameter (LAD), left atrial end-diastolic volume (LAEDV), left atrial contraction End-stage volume (LAESV), left atrial ejection fraction (LAEF) and adverse reactions. Results: Systolic pressure, diastolic pressure, LAEDV and LAESV were better than before treatment (P <0.05) after treatment, but there was no significant difference between the two groups (P> 0.05) There was no significant difference in heart rate, systolic blood pressure, diastolic blood pressure, LAD, LAEDV, LAESV and LAEF (P> 0.05). The incidence of adverse reactions in group B was significantly lower than that in group A (P> 0.05). Conclusion: Low dose amiodarone combined with losartan and high dose amiodarone combined with losartan in the treatment of paroxysmal atrial fibrillation is quite effective, but with fewer adverse reactions.