伊布利特对老年心房颤动射频消融术患者心肌损伤及术后复发的影响  

Effects of Ibutilide on Myocardial Injury and Postoperative Recurrence in Elderly Patients with Atrial Fibrillation Undergoing Radiofrequency Ablation

作　　者：赵荣诚[1] 韩佳[1] ZHAO Rong-cheng;HAN Jia(The First Department of Cardiology,the Central Hospital of Cangzhou,Cangzhou,Hebei 061001,China)

机构地区：[1]沧州市中心医院心血管内一科,河北沧州061001

出　　处：《临床误诊误治》2021年第6期34-38,共5页Clinical Misdiagnosis & Mistherapy

基　　金：沧州市科学技术研究与发展指导计划项目(172302089)。

摘　　要：目的观察术中应用伊布利特对老年心房颤动射频消融术患者心肌损伤标志物及术后复发的影响。方法选取2017年10月—2019年8月收治的老年心房颤动患者95例为研究对象。根据治疗方法不同将其分为对照组47例和观察组48例,对照组给予射频消融术治疗,观察组在射频消融术中应用伊布利特治疗。观察两组术后成功转复率和复发率,比较两组心肌损伤标志物、临床指标,以及不良反应发生情况。结果观察组成功转复率高于对照组(P<0.05);两组术后1周内复发率比较差异无统计学意义(P>0.05)。术后4 h,两组肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)及肌红蛋白(MYO)抗原水平均高于术前,但观察组上述指标低于对照组(P<0.05,P<0.01)。两组基线QT间期(QTc)、最大QTc比较差异无统计学意义(P>0.05);观察组复律时间、QTc达峰时间低于对照组(P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论射频消融术中应用伊布利特治疗可有效提高老年心房颤动患者的成功转复率,缩短转复时间,降低复发率;还能降低射频消融术对心肌的损伤,且治疗安全性高。Objective To observe effects of intraoperative application of Ibutilide on myocardial injury markers and postoperative recurrence in elderly patients with atrial fibrillation(AF)undergoing radiofrequency ablation(RFA).Methods A total of 95 elderly patients with AF admitted during October 2017 and August 2019 were selected as research subjects,and the patients were divided into control group(n=47)and observation group(n=48)according to different treatment methods.Control group was treated with RFA,while observation group was given Ibutilide during RFA.Successful conversion rate and recurrence rate after surgery were observed,and conditions of myocardial injury markers,clinical indicators and adverse reactions were compared between two groups.Results Successful conversion rate in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in recurrence rate within postoperative 1 week between two groups(P>0.05).At the 4 th h after surgery,levels of creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and myoglobin(MYO)antigen in two groups were significantly higher than those before surgery in two groups,but the above indicators in observation group were significantly lower than those in control group(P<0.05,P<0.01).There were no significant differences in baseline QTc and maximum QTc values between two groups(P>0.05).Time to cardioversion and QTc peak time in observation group were significantly lower than those in control group(P<0.05).There was no statistical difference in the total incidence rate of adverse reactions between two groups(P>0.05).Conclusion The application of Ibutilide during RFA may effectively improve successful conversion rate,shorten conversion time and reduce recurrence rate of elderly patients with AF.It may also reduce myocardial injury by RFA,and the treatment is safe.

关 键 词：心房颤动 老年人 导管消融术 射频 伊布利特 复发 肌酸激酶 MB型 肌钙蛋白I 

分 类 号：R541.75[医药卫生—心血管疾病]