不同剂量替米沙坦对急性心肌梗死患者P波离散度的影响

目的探讨不同剂量的替米沙坦对急性心肌梗死患者P波离散度(Pd)、最大P波时限(Pmax)及住院期间心房颤动(Af)发生率的影响。方法选择我院2006年1月至2009年1月间因急性心肌梗死住院治疗的患者共261例,采用替米沙坦干预,小剂量组予20~40 mg/d,大剂量组予60~80 mg/d,观察不同剂量组患者治疗前后Pd、Pmax的变化及住院期间Af的发生情况。结果治疗后与小剂量治疗组相比,大剂量治疗组患者Pmax、Pd均明显降低,差异有统计学意义(P<0.05);治疗后大剂量组较治疗前Pmax及Pd明显降低,差异有统计学意义(P<0.05);而在小剂量治疗组中,治疗后Pmax及Pd有下降的趋势,但差异无统计学意义(P>0.05);大剂量组住院期间AF的发生比例较小剂量组低,差异有统计学意义(P<0.05)。结论大剂替米沙坦较小剂量替米沙坦能更明显减小Pd及Pmax,同时减少住院期间Af的发生。

Effect of different dose of telmisartan on P wave dispersion in patients with acute myocardial infarction

Objective To observe the clinical efficacy of different dose of telmisartan on P wave dispersion（Pd）,maximum P wave duration（Pmax）,minimum P wave duration（Pmin） and atrial fibrillation（AF） incidence in patients with acute myocardial infarction（AMI）.Methods A total of 261 patients with AMI were choosed,patients in small dose group were treated with telmisartan 20~40 mg/d,patients in high dose group were treated with telmisartan 60~80 mg/d.Pd,Pmax and AF incidence before and after treatment in different dose groups were observed.Results Pd and Pmax in high dose group patients were significantly lower than those in small dose group patients after treatment（P0.05）.In high dose group,Pd and Pmax were lower after treatment,the difference was statistically significant（P0.05）.In small dose group,Pd and Pmax were lower after treatment,but the difference was not statistically significant（P0.05）.During hospitalization AF incidence in high dose group was lower than that in small dose group,the difference was statistically significant（P0.05）.Conclusion High dose telmisartan can reduce Pd,Pmax and AF incidence more effectively.