决奈达隆联合导管消融术治疗心房颤动患者的临床研究  

Clinical trial of dronedarone combined with catheter ablation in the treatment of patients with atrial fibrillation

作　　者：刘涛[1] 王梅[1] 张国茹[1] 张晓丹 张杨[1] 饶明月[1] 王亚玲[1] LIU Tao;WANG Mei;ZHANG Guo-ru;ZHANG Xiao-dan;ZHANG Yang;RAO Ming-yue;WANG Ya-ling(The First Department of Cardiology,East Hospital,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北医科大学第二医院东院心内一科,河北石家庄050000

出　　处：《中国临床药理学杂志》2023年第19期2739-2743,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察决奈达隆联合导管消融术治疗阵发性心房颤动的临床疗效以及对窦性心律维持情况的影响。方法将阵发性心房颤动患者分为对照组和试验组。对照组患者给予导管消融术+普罗帕酮150 mg,每天3次;试验组患者给予导管消融术+决奈达隆400 mg,每天3次。2组患者均治疗3个月。比较2组心房颤动患者心功能变化、炎症因子水平以及窦性心率维持情况。结果试验过程中脱落4例,最终试验组和对照组均纳入30例。术后3个月时,试验组和对照组的左心室收缩末期内径(LVESD)分别为(33.43±3.63)和(36.04±3.70)mm,左心室舒张末期内径(LVEDD)分别为(52.89±4.84)和(58.03±4.67)mm,左心房最大容积(LAMV)分别为(27.81±3.33)和(31.72±3.08)mL,左心室射血分数(LVEF)分别为(51.36±4.62)%和(47.76±4.21)%,血清脑钠肽(BNP)分别为(269.48±42.08)和(358.61±51.87)μmol·L^(-1),心肌肌钙蛋白Ⅰ(cTnⅠ)分别为(0.67±0.18)和(0.94±0.21)μg·L^(-1),同型半胱氨酸(Hcy)分别为(10.79±2.03)和(14.83±2.44)μmol·L^(-1),C反应蛋白(CRP)分别为(5.04±1.33)和(6.49±1.87)mg·L^(-1),肿瘤坏死因子-α(TNF-α)分别为(6.42±1.57)和(8.34±2.03)μmol·L^(-1),白细胞介素-6(IL-6)分别为(15.41±2.76)和(18.48±3.22)ng·mL^(-1),差异均有统计学意义(均P<0.05)。试验组术后12个月的窦性心律维持率为80.00%,高于对照组的53.33%(P<0.05)。结论决奈达隆联合导管消融术治疗可以增强心房颤动患者术后心功能,降低炎症反应,有利于患者术后窦性心律维持。Objective To analyze the clincial effect of dronedarone combined with catheter ablation on paroxysmal atrial fibrillation and its influences on the maintenance of sinus rhythm.Methods Patients with paroxysmal atrial fibrillation were divided into control group and treatment group.The control group was treated with catheter ablation and propafenone(150 mg,tid),while treatment group was treated with dronedarone(400 mg,bid)and catheter ablation.Two groups were treated for 3 months.The changes of cardiac function,levels of inflammatory factors and sinus rhythm maintenance were compared between the two groups.Results There were 4 cases lost during the treatment,and there were 30 cases in treatment group and 30 cases in control group.At 3 months after surgery,left ventricular end-systolic diameter(LVESD)in treatment group and control group were(33.43±3.63)and(36.04±3.70)mm;left ventricular end-diastolic diameter(LVEDD)were(52.89±4.84)and(58.03±4.67)mm;left atrial maximum volume(LAMV)were(27.81±3.33)and(31.72±3.08)m L;left ventricular ejection fraction(LVEF)were(51.36±4.62)%and(47.76±4.21)%;serum brain natriuretic peptide(BNP)were(269.48±42.08)and(358.61±51.87)μmol·L^(-1);cardiac troponinⅠ(CTnⅠ)were(0.67±0.18)and(0.94±0.21)μg·L^(-1);homocysteine(Hcy)were(10.79±2.03)and(14.83±2.44)μmol·L^(-1);C-reactive protein(CRP)were(5.04±1.33)and(6.49±1.87)mg·L^(-1);tumor necrosis factor-α(TNF-α)were(6.42±1.57)and(8.34±2.03)μmol·L^(-1);interleukin-6(IL-6)were(15.41±2.76)and(18.48±3.22)ng·m L^(-1);the differences were all statistically significant(all P<0.05).The sinus rhythm maintenance rate of treatment group was80.00%at 12 months after operation,which was higher than that of control group(53.33%,P<0.05).Conclusion Dronedarone combined with catheter ablation can enhance postoperative cardiac function and reduce inflammatory response in patients with atrial fibrillation,which is conducive to postoperative maintenance of sinus rhythm.

关 键 词：决奈达隆 心房颤动 导管消融术 心功能 窦性心律 

分 类 号：R972[医药卫生—药品]