室性早搏患者射频消融术预后与起源部位的相关性  

Correlation between the Prognosis of Radiofrequency Ablation and the Origins in Patients with Premature Ventricular Contractions

作　　者：葛俊炜 江冰 黄新苗[1] 徐迎辉 居海宁[2] GE Jun-wei;JIANG Bing;HUANG Xin-miao;XU Ying-hui;JU Hai-ning(Department of Cardiology,Changhai Hospital,Second Affiliated Hospital of Second Military Medical University,Shanghai,200433,China;Department of Cardiology,The 7th People's Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200137,China)

机构地区：[1]第二军医大学第一附属医院长海医院心血管内科,上海200433 [2]上海中医药大学附属第七人民医院心血管内科,上海200137

出　　处：《现代生物医学进展》2019年第22期4247-4250,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81770506)

摘　　要：目的:探讨室性早搏(PVCs)患者射频消融术(RFCA)预后与起源部位的相关性。方法:回顾性分析2016年12月~2017年12月第二军医大学第一附属医院长海医院心血管内科收治并接受RFCA治疗的PVCs患者的临床资料,根据起源部位分为右心室组(n=58),左心室组(n=24)。记录两组RFCA手术时间、X线曝光时间及手术成功率等指标,术后随访6个月,比较两组术后心功能指标的改善情况,记录24h PVCs总数及复发情况。结果:与左心室组比较,右心室组手术时间、X线曝光时间明显延长,手术成功率明显下降(P<0.05)。术后3个月,右心室组LVESD、LVEDD均明显减小,LVEF明显升高(P<0.05);术后6个月,两组24h PVCs数均较术前显著降低,且右心室组下降幅度更为显著(P<0.05)。术后6个月,两组各心功能指标均较术前明显改善,右心室组较术后3个月进一步改善,且明显优于左心室组(P<0.05)。结论:射频消融术治疗PVCs的预后与起源部位存在一定相关性,右心室起源相对左心室起源的PVCs手术成功率更高,更有利于抑制心室重构、改善心功能。Objective: To explore the correlation between the prognosis of radiofrequency ablation(RFCA) and the origins in patients with premature ventricular contractions(PVCs). Methods: Clinical data of PVCs patients admitted to the department of cardiovascular medicine of Changhai hospital, the first affiliated hospital of the second military medical university, and treated with RFCA from December 2016 to December 2017 were retrospectively analyzed, and were divided into right ventricle group(n=58) and left ventricle group(n=24) according to the origins. The operation time of RFCA, X-ray exposure time, operation success rate and other indicators of the two groups were recorded. The patients were followed up for 6 months after the operation. The improvement of cardiac function indicators in the two groups after the operation was compared, and the total number of 24 h PVCs and the recurrence were recorded. Results: Compared with the left ventricle group, the operation time and X-ray exposure time in the right ventricle group were significantly prolonged, and the success rate of surgery was significantly decreased(P<0.05). At 6 months after surgery, the number of24 h PVCs in both groups was significantly lower than that before surgery, and the decline was more significant in the right ventricle group(P<0.05). Three months after surgery, LVESD and LVEDD were significantly decreased and LVEF was significantly increased in the right ventricle group(P<0.05). At 6 months after surgery, all cardiac function indicators in the two groups were significantly improved compared with those before surgery, and the right ventricle group was further improved compared with that at 3 months after surgery, and was significantly better than that in the left ventricle group(P<0.05). Conclusions: The prognosis of PVCs has a certain correlation with the site of origin. The success rate of right ventricular origin PVCs is higher than that of left ventricular origin, which is more conducive to improving cardiac structural remodeling and function.

关 键 词：室性早搏 射频消融术 起源部位 预后 

分 类 号：R541.7[医药卫生—心血管疾病]