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目的探讨福辛普利联合胺碘酮和非洛地平对高血压合并房颤者复律后窦律维持情况的作用。方法选择武汉大学人民医院2006年1月—2009年1月收治的阵发性房颤患者97例,经药物或者电复律后,随即分为观察组和对照组。观察组给予胺碘酮、非洛地平和福辛普利,对照组给予胺碘酮和非洛地平。治疗随访时间为1a,终点事件是房颤复发,观察2组复律后2、4、6、8、10、12个月内窦性心律的维持人数,同时观察血压的维持水平,心脏结构和功能的变化。结果在房颤复律后第6、8、10、12个月,观察组的窦律维持人数高于对照组,且差异具有统计学意义(P<0.05)。2组血压稳定下降,差异无统计学意义。观察组治疗1a后心脏结构和功能明显优于对照组(P<0.05)。结论使用福辛普利联合胺碘酮和非洛地平比单用胺碘酮和非洛地平更有利于高血压合并房颤患者复律后窦律的维持。
Objective To investigate the effect of fosinopril combined with amiodarone and felodipine on the maintenance of sinus rhythm after cardioversion in patients with hypertension and atrial fibrillation. Methods Ninety-seven patients with paroxysmal atrial fibrillation who were admitted to Wuhan University People’s Hospital from January 2006 to January 2009 were randomly divided into observation group and control group after drug or cardioversion. The observation group was given amiodarone, felodipine and fosinopril, while the control group was given amiodarone and felodipine. The treatment follow-up time was 1a, the end point was the recurrence of atrial fibrillation. The number of sinus rhythm maintenance was observed in 2, 4, 6, 8, 10 and 12 months after cardioversion in both groups. At the same time, the maintenance of blood pressure, heart structure and Functional changes. Results At the 6th, 8th, 10th and 12th months after cardioversion, the number of sinus rhythm maintained in the observation group was significantly higher than that in the control group (P <0.05). 2 groups of blood pressure decreased steadily, the difference was not statistically significant. The structure and function of the heart in the observation group after 1a treatment were significantly better than those in the control group (P <0.05). Conclusions The use of fosinopril in combination with amiodarone and felodipine is more beneficial than the single amiodarone and felodipine alone in the maintenance of sinus rhythm after cardioversion in patients with hypertension and atrial fibrillation.