摘要
目的探讨原发性高血压(EH)合并阵发性心房颤动(PAF)患者血清内皮素(ET)、血管紧张素Ⅱ(Ang Ⅱ),P波最大时限(Pmax)、P波离散度(Pd)和左心房内径(LAD)的变化,苯那普利的干预作用及预防PAF的机制.方法选择24例健康人做对照(正常对照组),另选择1、2级EH并PAF的患者53例,采用放射免疫法测定血清中ET、Ang Ⅱ浓度,通过12导联同步心电图测定Pmax 、Pd,采用彩色多普勒诊断仪测量LAD,观察苯那普利、利尿剂对ET、Ang Ⅱ、Pmax 、Pd、LAD的影响及预防PAF的效果.结果 1、2级EH并PAF组血清ET、Ang Ⅱ浓度明显高于正常对照组(P<0.001),P max 、Pd、LAD明显大于正常对照组(P<0.001),EH并AF病人服用苯那普利6月后,血清ET、Ang Ⅱ浓度明显降低,Pmax 、Pd明显减小(P<0.05～0.01),LAD无明显扩大(P>0.05).随访6月中苯那普利组房颤发作次数和持续时间明显低于利尿剂组(P<0.001).结论 ET、Ang Ⅱ、Pmax、Pd、LAD在EH并PAF病人中明显增加,苯那普利可降低ET、Ang Ⅱ、Pmax、Pd,延缓LAD的扩大,预防PAF的复发.
Objective To study the effects of benazepril on serum level of endothelin（ET）, angiotensin Ⅱ （Ang Ⅱ ）, P-wave duration（Pmax） , P-wave dispersion （Pd） and the left atrial diameter（LAD） in hypertensive patients with paroxysmal atrial fibrillation（PAF） , and explore the possible mechanism. Methods Serum ET and Ang Ⅱ concentrations were measured with immunoradiometric assay; Pmax Pd were measured by 12-lead surface electrocardiogram, and LAD were measured by Color Doppler echocardiography in 53 EH patients with PAF and 24 healthy（control group）. The effects of diuretic （n=24） and benazepril （n=29） were evaluated. Results Serum ET, Ang Ⅱ and Pmax Pd, LAD were significantly increased in patients with stage 1 or 2 hypertension with PAF as compared with control group （P〈0. 001 ） ; 6 months treatment with benazepril（ 10 mg/d） significantly decreased ET, Ang Ⅱ , Pmax Pd and recurrence of PAF compared with diuretic group （P〈0. 05 - 0. 001）. Conclusion ET, Ang Ⅱ , Pmax Pd, LAD in patients of hypertension with PAF were significantly higher than in the controls; benazepril reduced ET, Ang Ⅱ , Pmax Pd, delayed the enlargement of the left atrium and prevented the recurrence of PAF.
出处
《高血压杂志》
CSCD
北大核心
2005年第9期537-540,共4页
Chinese Journal of Hypertension
