螺内酯联用胺碘酮治疗阵发性房颤的临床观察

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1、螺内酯联用胺碘酮治疗阵发性房颤的临床观察汕头市第二人民医院515000钟伟文【摘要】目的观察螺内酯联用胺碘酮在阵发性房颤转复后维持窦性心律的作用及对左房功能的影响。方法　选择非瓣膜性阵发性房颤患者100例，药物或电复律后随机分2组：对照组予胺碘酮0.2g，1次/d；观察组在服胺碘酮的基础上予螺内酯20mg，1次/d。观察复律前及第12个月左心房功能变化和房颤复发情况。结果　随访1年后,对照组心房颤动复发21例，占42%，观察组复发9例，占18%，两组比较差异有统计学意义(χ2=5.6471，P<0.05)。观察组复律后12个月超声心动图测得LAD，LAEDV、LAESV较前减少(P<0

2、.05),而对照组患者LAD、LAEDV、LAESV各指标治疗前后比较无显著性差异(P>0.05)。两组患者均未见明显的不良反应。结论　螺内酯联用胺碘酮在非瓣膜性阵发性房颤转复后维持窦性心律较单用胺碘酮有效，而且能改善左房功能。【关键词】螺内酯；胺碘酮；阵发性房颤[中图号][文献标识码]TheClinicalobservationofSpironolactonecombinedwithamiodaroneinthetreatmentofparoxysmalatrialfibrillationZhongWei-wen,The2ndhospitalofshantou，515000Abstr

3、act　ObjectiveObservationofSpironolactonecombinedwithamiodaroneinthetreatmentofthepatientswithparoxysmalatrialfibrillation,andtomaintainsinusrhythmafterconversionanditseffectsonleftatrialfunction.MethodsSelectnon-valvularparoxysmalatrialfibrillationin100patients,drugsorelectricalcardioversionwere

4、randomlydividedinto2groups:controlgroupIamiodarone0.2g,1times/d;ObserverGrouponthebasisofamiodaroneintheclothesIspironolactone20mgand1/d.Observedbeforecardioversionand12-monthchangesinleftatrialfunctionandatrialfibrillationrecurrence.ResultsFollow-uponeyearafterrecurrenceofatrialfibrillationinth

5、econtrolgroup21cases,accountingfor42%,9casesofrecurrenceoftheobservationgroup,accountingfor18%,thedifferencewasstatisticallysignificant(χ2=5.6471,P<0.05).Theobservationgroup12monthsaftercardioversionofechocardiographymeasuredLAD,LAEDV,LAESVlessthanbefore(P<0.05),whilethecontrolgroup,patientswith

6、LAD,LAEDV,LAESVtheindicatorsbeforeandaftertreatmentshowednosignificantdifference(P>0.05).Twogroupsofpatientshadnoobviousadversereactions.ConclusionsSpironolactonecombinedwithamiodaroneinnon-valvularparoxysmalatrialfibrillationtomaintainsinusrhythmafterconversionthanamiodaronealoneeffective,butal

7、socanimproveleftatrialfunction.KeywordsSpironolactone;amiodarone;paroxysmalatrialfibrillation.心房颤动(Af)是临床最常见的心律失常之一。胺碘酮是治疗房颤的常用药物,主要用于心房颤动的转复和窦性心律的维持。近年来许多基础与临床研究表明，房颤存在与发展的机制为左房的组织重构与电重构，并且与肾素-血管紧张素-醛固酮系统密切相关。醛固酮受体拮抗剂等非抗心律失