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目的:通过探讨不同剂量胺碘酮联合氯沙坦治疗阵发性房颤(PAF)患者的临床疗效,为PAF的治疗提供参考。方法:选择2013年6月~2014年6月本院收治的PAF患者共84例,按照随机数字表法随机分为大剂量组和小剂量组,分别在治疗1、3、6、12个月后观察两组患者窦性心律维持效果、左心室功能和血清高敏C反应蛋白(Hs-CRP)水平。结果:治疗1个月后,两组患者窦性心律维持效果的总有效率分别为93.73%和90.00%,差异无统计学意义(x~2=2.235;P>0.05)。治疗3、6和12个月后,小剂量组患者窦性心律维持有效率均高于大剂量组,差异有统计学意义(x~2=4.208、5.271、5.688;P<0.05)。小剂量组患者最大P波时限(Pmax)、P波离散度(Pd)和左心房直径(LAD)值均显著低于大剂量组患者,差异有统计学意义(t=-6.071、-3.509、-3.998;P<0.05);左心室射血分数(LVEF)值显著高于大剂量组患者,差异有统计学意义(t=3.935;P<0.05)。治疗1、6和12个月后,小剂量组血清Hs-CRP水平均低于大剂量组,差异有统计学意义(t=-4.515、-10.431、-19.113;P<0.05)。结论:小剂量胺碘酮联合氯沙坦能够有效提高阵发性房颤患者窦性心律维持效果,改善患者左心室功能,降低Hs-CRP水平,值得临床推广借鉴。
Objective: To explore the clinical efficacy of different doses of amiodarone combined with losartan in the treatment of patients with paroxysmal atrial fibrillation (PAF), and provide a reference for the treatment of PAF. Methods: A total of 84 PAF patients admitted to our hospital from June 2013 to June 2014 were randomly divided into high-dose group and low-dose group according to random number table. The effects of sinus rhythm maintenance, left ventricular function and serum high-sensitivity C-reactive protein (Hs-CRP) levels were observed in both groups. Results: After 1 month of treatment, the total effective rate of sinus rhythm maintenance in both groups was 93.73% and 90.00%, respectively, with no significant difference (x ~ 2 = 2.235; P> 0.05). After 3, 6 and 12 months of treatment, the effective rate of sinus rhythm maintenance in patients in low dose group was higher than that in large dose group (x ~ 2 = 4.208,5.271,5.688; P <0.05). The maximum P wave length, P wave dispersion (Pd) and left atrial diameter (LAD) of the low dose group were significantly lower than those of the high dose group, the difference was statistically significant (t = -6.071, -3.509, -3.998; P <0.05). The LVEF was significantly higher than that of the high-dose group (t = 3.935; P <0.05). After 1, 6 and 12 months of treatment, the levels of serum Hs-CRP in the low-dose group were significantly lower than those in the high-dose group (t = -4.515, -10.431, -19.113, P <0.05). Conclusion: Low-dose amiodarone combined with losartan can effectively improve sinus rhythm maintenance in patients with paroxysmal atrial fibrillation, improve left ventricular function and reduce Hs-CRP in patients with atrial fibrillation, which is worthy of clinical promotion.