文章摘要

胺碘酮联合厄贝沙坦治疗高血压病合并阵发性房颤对患者血清B型钠尿肽、血管紧张素及基质金属蛋白酶-2水平的影响

作者: 1程亚玲, 2陈捷, 1陈海燕, 1庹田, 1刘丁铭
1 四川大学华西广安医院心血管内科,四川 广安 638000
2 四川大学华西广安医院神经内科,四川 广安 638000
通讯: 陈捷 Email: 14292399@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.09.011
基金: 四川省医学会科研课题(Q17035)。

摘要

目的:探讨胺碘酮联合厄贝沙坦治疗高血压病合并阵发性房颤对患者血清B型钠尿肽(B-type natriuretic peptide,BNP)、血管紧张素II(angiotensin II,AngII)及基质金属蛋白酶-2(matrix metalloproteinase 2,MMP-2)水平的影响。方法:采用随机数字表法将96例高血压病合并阵发性房颤患者分为观察组与对照组,每组各48例。观察组患者予以胺碘酮+厄贝沙坦治疗,对照组患者予以胺碘酮+硝苯地平治疗。比较两组患者临床疗效和不良反应发生率,观察治疗前后血压、房颤发作次数、发作持续时间、左心房内径以及血清BNP,AngII,MMP-2水平变化情况。结果:观察组患者治疗总有效率高于对照组(P<0.05);治疗12个月后,两组患者收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)均较治疗前降低(P<0.05),组间比较差异无统计学意义(P>0.05);两组患者房颤发作次数较治疗前减少,发作持续时间较治疗前缩短,左心房内径较治疗前缩小(P<0.05),且观察组上述指标改善情况好于对照组(P<0.05);两组患者血清BNP,MMP-2水平及观察组患者血清AngII水平均较治疗前降低(P<0.05),且观察组上述指标水平明显低于对照组(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:胺碘酮联合厄贝沙坦治疗高血压病合并阵发性房颤疗效好且安全性高,可有效控制血压,减少房颤发作,抑制左心房扩大,并能降低患者血清BNP,AngII及MMP-2水平。
关键词: 胺碘酮;厄贝沙坦;高血压;阵发性房颤;B型钠尿肽;基质金属蛋白酶-2

Effects of amiodarone combined with irbesartan on levels of serum BNP, AngII and MMP-2 in patients with hypertension complicated with paroxysmal atrial fibrillation

Authors: 1CHENG Yaling, 2CHEN Jie, 1CHEN Haiyan, 1TUO Tian, 1LIU Dingming
1 Department of Cardiovascular Medicine, West China-Guang’an Hospital, Sichuan University, Guang’an Sichuan 638000, China
2 Department of Neurology, West China-Guang’an Hospital, Sichuan University, Guang’an Sichuan 638000, China

CorrespondingAuthor: CHEN Jie Email: 14292399@qq.com

Foundation: This work was supported by the Scientific Research Project of Sichuan Medical Association, China (Q17035).

Abstract

Objective: To explore the effects of amiodarone combined with irbesartan on levels of serum B-type natriuretic peptide (BNP), angiotensin II (Ang II) and matrix metalloproteinase-2 (MMP-2) in patients with hypertension complicated with paroxysmal atrial fibrillation. Methods: A total of 96 patients with hypertension and paroxysmal atrial fibrillation were divided into an observation group and a control group according to the random number table method, with 48 cases in each group. The observation group was given amiodarone + irbesartan, and the control group was given amiodarone + nifedipine. The clinical efficacy and incidence rate of adverse reactions were compared between the two groups. The blood pressure, frequency of atrial fibrillation attack, attack duration, left atrial diameter and levels of serum BNP, AngII and MMP-2 were observed before and after treatment. Results: The total effective rate of treatment in observation group was higher than that in control group (P<0.05). After 12 months of treatment, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the two groups were decreased compared with those before treatment (P<0.05), and there were no significant differences between the two groups (P>0.05). The frequency of atrial fibrillation attack in the two groups was decreased compared with that before treatment, and the attack duration was shortened compared with that before treatment, and the left atrial diameter was reduced compared with that before treatment (P<0.05), and the improvement of the above indicators in observation group was better than that in control group (P<0.05). The serum BNP and MMP-2 in the two groups and serum AngII level in observation group were decreased compared with those before treatment (P<0.05), and the levels of above indicators in observation group were significantly lower than those in control group (P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion: Amiodarone combined with irbesartan has good efficacy and high safety in the treatment of hypertension with paroxysmal atrial fibrillation. And it can effectively control blood pressure, reduce the attacks of atrial fibrillation, inhibit left atrial enlargement, and reduce levels of serum BNP, AngII and MMP-2.
Keywords: amiodarone; irbesartan; hypertension; paroxysmal atrial fibrillation; B-type natriuretic peptide; matrix metalloproteinase-2