李茹 李华 王焕鹏 郭亚丹

【摘要】 目的 探讨尼非卡兰联合厄贝沙坦在阵发性房颤患者中的应用效果。

方法 选取2018年5月～2020年5月收治的60例阵发性房颤患者，依据随机数字表分为对照组与研究组，各30例。对照组采用厄贝沙坦联合胺碘酮治疗，研究组采用厄贝沙坦联合尼非卡兰治疗，均治疗3个月。比较两组治疗前及治疗3个月时的房颤发作情况及P波变化情况。

结果 治疗前，两组患者的房颤发作次数、房颤持续时间比较，差异无统计学意义（P>0.05）;治疗3个月后，两组房颤发作次数、房颤持续时间均低于治疗前，且研究组患者的上述指标低于对照组，差异有统计学意义（P<0.05或0.01）;治疗前，两组最大P波时限（Pmax）、最小P波时限（Pmin）、P波离散度（Pd）值比较，差异无统计学意义（P>0.05）;治療3个月后，两组Pmax、Pmin、Pd均低于治疗前，且研究组上述指标低于对照组，差异有统计学意义（P<0.05或0.01）;研究组不良反应总发生率低于对照组，差异有统计学意义（P<0.05）。

结论 尼非卡兰联合厄贝沙坦治疗能降低阵发性房颤发作次数，缩短发作持续时间，降低不良反应的发生风险。

【关键词】 阵发性房颤;尼非卡兰;厄贝沙坦;房颤发作;P波离散度

中图分类号：R541.7+ 文献标志码： DOI：10.3969/j.issn.10031383.2021.06.008

Application of nifekalant combined with irbesartan in patients with paroxysmal atrial fibrillation

LI Ru1LI Hua2WANG Huanpeng3GUO Yadan1

（1. Department of Cardiovascular Medicine， 2. Emergency Department， 3. Department of Burn Repair Surgery， No.988 Hospital of Joint Logistics Support Force of the Chinese People' s Liberation Army， Zhengzhou 450000， Henan， China）

【Abstract】 Objective To explore the application effect of nifekalant combined with irbesartanin patients with paroxysmal atrial fibrillation.

Methods 60 patients with paroxysmal atrial fibrillation admitted thospital from May 2018 to May 2020 were selected， and they were divided into control group and study group by random number table， with 30 cases in each group. The control group were treated with irbesartan combined with amiodarone， and the study group were treated with irbesartan combined with nifekalant， both of which were treated for 3 months. And then， the atrial fibrillation attacks and Pwave changes of the two groups before and after 3 months of treatment were compared.

Results Before treatment， there was no statistically significant difference in the frequency of atrial fibrillation attacks and the duration of atrial fibrillation between the two groups （P > 0.05）; after 3 months of treatment， the frequency of atrial fibrillation attacks of both groups were less than those before treatment， and the duration of atrial fibrillation were shorter， and abovementioned indexes in the study group were lower than those in the control group， with statistically significant difference （P < 0.05 or 0.01）; before treatment， there was no statistically significant difference in maximum Pwave duration （Pmax）， minimum Pwave duration （Pmin） and Pwave dispersion （Pd） of both groups（P > 0.05）; after 3 months of treatment， Pmax， Pmin and Pd in both groups were lower than those before treatment， and the abovementioned indexes in the study group were lower than those in the control group， with statistically significant difference （P < 0.05 or 0.01）; the total incidence of adverse reactions in the study group was lower than that of the control group， with statistically significant difference （P < 0.05）.

Conclusion Nifekalant combined with irbesartan can reduce the frequency of atrial fibrillation attacks， shorten the duration of atrial fibrillation， and reduce the risk of adverse reactions.

【Key words】 paroxysmal atrial fibrillation; nifekalant; irbesartan; atrial fibrillation attack; Pd

阵发性房颤多发于存在器质性心脏病的患者中，是临床上最为常见的一种心律失常。阵发性房颤患者多伴有心悸、胸闷等症状，若不及时给予有效治疗，将增加急性心力衰竭、心绞痛、休克等并发症的发生风险，危及患者生命安全[1]。胺碘酮联合厄贝沙坦是临床上治疗阵发性房颤的常用方式，其中厄贝沙坦是一种血管紧张素受体拮抗剂，可抑制房颤结构重构及电重构;胺碘酮是临床上较为常见的一种抗心律失常药，其与厄贝沙坦联合应用时，虽能改善患者的临床症状，但部分患者在应用后出现畏光、视物模糊等症状，在一定程度上降低了治疗效果[2]。尼非……