中文摘要：

目的：评价替米沙坦联合胺碘酮治疗慢性心力衰竭合并阵发性房颤的临床疗效及安全性。方法：选择我院收治的慢性心衰合并阵发性房颤患者167例,均使用胺碘酮维持窦性心律,根据患者是否加用替米沙坦分为治疗组及对照组。治疗1年后,观察和比较两组的心衰住院率、左室射血分数、左房内径、心功能分级、窦性心律维持率、房颤复发率等。结果：治疗组房颤的复发率、慢性房颤的发生率均明显低于对照组,窦性心律维持率明显高于对照组,左房内径较对照组明显减小,心衰住院率明显低于对照组,差异均有统计学意义（P〈0.05）。两组不良反应（如甲状腺功能异常、肝功能异常、肺纤维化和低血压）的发生率比较无统计学差异（P〉0.05）。结论：替米沙坦联合胺碘酮对于慢性心力衰竭伴阵发性房颤患者能较好地维持窦性心律,降低心衰住院率,对心脏重构有较好的改善作用,且具有良好的安全性。

英文摘要：

Objective：To investigate the effect of telmisartan combined with amiodarone in the treatment of chronic heart failure with paroxysmal atrial fibrillation.Methods： 167 patients of chronic heart failure with paroxysmal atrial fibrillation were enrolled in this study,amiodarone was used to maintain sinus rhythm.All of the patients were divided into the treatment group and the control group according to the combined treatment of telmisartan.After one year＇s treatment,the hospitalization for heart failure rate,left ventricular ejection fraction,left atrial diameter,the rate of sinus rhythm maintenance and the rate of permanence atrial fibrillation were observed and analysed.Results： The rate of recurrence of atrial fibrillation and the incidence of chronic atrial fibrillation in the treatment group was significantly lower than that of the control group;sinus rhythm maintenance rate was significantly higher than that of the control group,left atrial diameter was significantly reduced compared with the control group,the rate of hospitalization for heart failure was significantly lower than that of the control group（P0.05）.There was no significant difference in adverse reactions between the two groups（thyroid dysfunction,abnormal liver function,pulmonary fibrosis and hypotension,P0.05）.Conclusion： The treatment of telmisartan combined with amiodarone for chronic heart failure with paroxysmal atrial could maintain sinus rhythm,reduce the rate of hospitalization for heart failure,and has a better effect on myocardial remodeling with good security.