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目的探讨依那普利联合厄贝沙坦片治疗心力衰竭和心房颤动的疗效。方法常规组使用地高辛,利尿剂,ACEI(依那普利),抗凝剂治疗(高血压,高血糖、高血脂使用降压,降糖,调脂药物)厄贝沙坦治疗组常规组治疗方案基础上加服厄贝沙坦,从150mg/d开始,逐渐增加至300mg/d,当静息时心室率小于50次/min和(或)收缩压小于90mmHg及时减量,无上述情况,则继续使用原方案。结果治疗组房颤复发6例(10.17%)明显低于对照组的7例(22.58%)差异有显者性意义(P<0.05)。结论AngII受体阻滞剂与ACEI联合应用,在心脏重构和防治心衰机制协同作用出发,联合依那普利和厄贝沙坦作为干预药物,双重拮抗AngII阻断肾素血管紧张系统,不以致善心功能,还明显减少房颤的复发率,致善患者的生活质量。
Objective To investigate the efficacy of enalapril combined with irbesartan in the treatment of heart failure and atrial fibrillation. Methods The routine group was treated with digoxin, diuretics, ACEI (enalapril), anticoagulant therapy (hypertension, hyperglycemia, hyperlipidemia using antihypertensive, hypoglycemic, lipid-lowering drugs) On the basis of group therapy, irbesartan plus 150mg / d gradually increased to 300mg / d, when resting ventricular rate was less than 50 beats / min and systolic blood pressure less than 90mmHg timely reduction, without the above The situation, then continue to use the original program. Results The recurrence of atrial fibrillation in the treatment group was significantly lower than that in the control group (10.17% vs 7.58%, P <0.05). Conclusions AngII receptor antagonist is used in combination with ACEI. Based on the synergistic effect of cardiac remodeling and prevention and treatment of heart failure, enalapril and irbesartan are used as the intervention drugs to antagonize AngII by blocking the renin-angiotensin system. As a result, the heart-care function also significantly reduces the recurrence rate of atrial fibrillation and improves the quality of life of the patients.