阿司匹林联合阿托伐他汀预防非体外循环下冠状动脉旁路移植术后新发房颤的临床研究  

Clinical study of aspirin combined with atorvastatin in the prevention of new onset atrial fibrillation after off-pump coronary artery bypass grafting

作　　者：白辰[1] 李京倖[1] 张帆[1] 高铭鑫[1] 刘锐[1] 李海洋 Bai Chen;Li Jingxing;Zhang Fan;Gao Mingxin;Liu Rui;Li Haiyang(Department of Cardiac Surgery,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]北京市心肺血管疾病研究所、首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中华胸心血管外科杂志》2023年第3期148-152,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81770320)。

摘　　要：目的探讨阿司匹林联合阿托伐他汀预防非体外循环下冠状动脉旁路移植(OPCABG)术后新发房颤(POAF)的临床价值。方法选取首都医科大学附属北京安贞医院2019年6月至2021年6月收治的208例冠状动脉旁路移植术患者,其中男168例,女40例;年龄40~72岁,平均(55.40±2.80)岁。随机数字表法分为对照组(104例,术前应用阿司匹林)和观察组(104例,术前联合应用阿司匹林和阿托伐他汀)。术后连续7天监测患者心电图,记录POAF发生情况,包括房颤(AF)持续时间、AF发生率及不良反应情况;观察并记录手术前、后左心房内径和高敏C反应蛋白(hs-CRP)水平。结果两组均无不良反应发生。观察组AF发生率明显低于对照组,差异有统计学意义(P<0.05),观察组每次AF持续时间优于对照组,差异有统计学意义(P<0.05)。治疗前,两组左心房内径和hs-CRP水平差异无统计学意义(P>0.05)。治疗后,观察组左心房内径恢复至治疗前,组内比较差异无统计学意义(P>0.05);对照组左心房内径高于治疗前,组内比较差异有统计学意义(P<0.05);观察组hs-CRP水平低于对照组,差异有统计学意义(P<0.05)。结论阿司匹林联合阿托伐他汀预防OPCABG术后POAF效果明显,无不良影响,术后POAF发生率降低,AF持续时间缩短,左心房内径得到有效控制,术后炎症反应减轻,值得临床推广应用。Objective To explore the clinical value of aspirin combined with atorvastatin in the prevention of new onset atrial fibrillation after off-pump coronary artery bypass grafting(OPCABG).Methods 208 patients with coronary artery bypass grafting in our hospital from June 2019 to June 2021 were selected as the research subjects and divided by a random number table method into groups.The control group(104 cases)was treated with aspirin before operation,and the observation group(104 cases)was treated with aspirin and atorvastatin before operation.ECG monitoring was carried out continuously for 7 days of patients in the two groups,and the occurrence and duration of AF were recorded.The clinical therapeutic efficacy,incidence and adverse reactions of AF,left atrial diameter and high-sensitivity C-reactive protein(hs-CRP)level were observed before and after treatment.Results The incidence of AF in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).There was no statistical significant difference in the starting time of AF between the two groups after operation(P>0.05).The duration of AF in the observation group was better than that in the control group,the difference was statistically significant(P<0.05).Before treatment,there was no statistical significant difference in left atrial diameter and hs-CRP level between the two groups(P>0.05).After treatment,the left atrial diameter in the observation group returned to that before treatment,and there was no statistical significant difference in the same group(P>0.05).The left atrial diameter in the control group was higher than that before treatment,and there was statistical significant difference in the same group(P<0.05).The level of hs-CRP was lower than that in the control group,the difference was statistically significant(P<0.05).There were no adverse reactions in both groups.Conclusion Aspirin combined with atorvastatin has a significant effect in preventing new onset AF after OPCABG.It can red

关 键 词：阿司匹林 阿托伐他汀 冠状动脉旁路移植术 心房颤动 临床价值 

分 类 号：R654.2[医药卫生—外科学]