美托洛尔联合参松养心胶囊对阵发性心房颤动患者P波离散度和血浆高敏C-反应蛋白的影响  

Effect of Metoprolol Combined With Shensongyangxin Capsule on P Wave Dispersion and Plasma High Sensitivity C-Reactive Protein in Patients With Paroxysmal Atrial Fibrillation

作　　者：金壹伍[1] 金振一[1] 马兰[1] 吕滨[1] 

机构地区：[1]延边大学附属医院心内科,吉林省延吉市133000

出　　处：《中国循环杂志》2012年第5期353-356,共4页Chinese Circulation Journal

基　　金：吉林省教育厅"十一.五"科学技术研究项目吉教科合字[2010]第9号

摘　　要：目的:探讨美托洛尔联合参松养心胶囊对阵发性心房颤动(PAF)患者的P波离散度(Pd)和血浆高敏C-反应蛋白(hs-CRP)的影响。方法:本研究共入选患者129例,其中PAF患者(PAF组)67例并随机分为3个亚组:美托洛尔组(A组,n=22)、参松养心胶囊组(B组,n=21)、美托洛尔和参松养心胶囊联合组(C组,n=24),62例窦性心律患者为对照组。比较PAF组和对照组治疗前后最大P波时限、Pd、血浆hs-CRP及左心房内径(LAD),疗程为3个月,观察PAF的复发率。结果:治疗前PAF组最大P波时限、Pd、血浆hs-CRP水平均高于对照组(P<0.05);A、B、C组治疗3个月后最大P波时限、Pd、血浆hs-CRP水平(不含A组)及PAF的复发率均降低,差异均有统计学意义(P<0.05～0.01);Pd≥40 ms比最大P波时限≥110 ms对预测PAF患者的敏感性和阴性预测值降低,但特异性和阳性预测值升高,最大P波时限≥110ms且P波离散度≥40 ms对预测PAF患者的特异度和阳性预测值均比单一指标高。结论:美托洛尔联合参松养心胶囊可以有效地降低PAF患者的最大P波时限、Pd、血浆hs-CRP水平和PAF的复发率。Objective：To explore the effect of metoprolol combined with shensongyangxin capsule on P wave dispersion （Pd） and high sensitivity C-reactive protein （hs-CRP） in patients with paroxysmal atrial fibrillation （PAF）. Methods ：A total of 129 patients were divided into two groups, Control group,n= 62,the patients with sinus rhythm and PAF group, n--67, those patients were further divided into three subgroups as Metoprolol （M） group, n = 22, Shensongyangxin capsule （S） group, n = 21 and M＋S group, n = 24. The Maximum P wave duration （ Pmax）, Pd, plasma hs-CRP level and PAF recurrence rate were compared before and after 3 months treatment in different groups. Results：Before treatment, Pmax, Pd and plasma hs-CRP level in PAF group were higher than those in Control group P〈 0.05. After 3 months treatment, Pmax, Pd and PAF recurrence rate in M, S and M＋S subgroups were decreased,P〈O. O1 -O. 05. For PAF patients,the sensitivity and negative predictive value of Pd〉40 ms was lower than that of Pmax= 110 ms,while the spe- cificity and positive predictive value was higher. The specificity and positive predictive value of Pmax = 110 ms with Pd 〉40 ms was higher than the single index. Conclusion：M-S treatment could effectively decrease Pmax, Pd in PAF patients and reduce PAF recurrence rate in clinical practice.

关 键 词：P波离散度 高敏C反应蛋白 阵发性心房颤动 美托洛尔 参松养心胶囊 

分 类 号：R541[医药卫生—心血管疾病]