他汀类药物治疗心房颤动射频消融术后患者的临床研究  

Clinical trial of statins in the treatment of patients with atrial fibrillation after radiofrequency ablation

作　　者：秦菘[1] 陈静[1] 张强[1] 张海强 余美群 王靖 QIN Song;CHEN Jing;ZHANG Qiang;ZHANG Hai-qiang;YU Mei-qun;WANG Jing(Department of Cardiovascular Medicine,Xinjiang Production and Construction Corps Seventh Division Hospital,Kuitun 833200,Xinjiang Uygur Autonomous Region,China;Department of Cardiology,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100000,China)

机构地区：[1]新疆生产建设兵团第七师医院心血管内科,新疆维吾尔自治区奎屯833200 [2]中国医学科学院阜外医院心内科,北京100000

出　　处：《中国临床药理学杂志》2023年第23期3356-3360,共5页The Chinese Journal of Clinical Pharmacology

基　　金：胡杨河市财政科技计划基金资助项目(2022A07)。

摘　　要：目的观察左心耳容积及他汀类药物对心房颤动射频消融术后心功能的影响。方法将成功完成射频消融术的心房颤动患者随机分为对照组和试验组,并根据术后1个月复发情况分为复发组与未复发组。对照组术后给予华法林5 mg抗凝治疗,qd;试验组术后口服瑞舒伐他汀10 mg或阿托伐他汀20 mg,qd,2组患者均治疗1个月。比较2组患者的炎症指标[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]、血脂指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、心功能指标[左心房射血分数(LAEF)、A峰、左心房最大应变值、左心房容积(LAV)、左心耳容积(LAAV)]水平。结果本研究共入组88例患者,其中,对照组45例、试验组43例。消融后1个月,试验组与对照组的血清IL-6水平分别为(6.27±1.24)和(12.06±1.13)ng·L^(-1),血清hs-CRP水平分别为(1.42±0.37)和(9.25±0.91)ng·L^(-1),LAEF分别为(59.12±1.65)%和(50.07±2.48)%,A峰值分别为69.74±1.65和62.49±2.67,左心房最大应变值分别为36.89±1.94和31.42±2.26。试验组的上述指标与对照组比较,差异均有统计学意义(均P<0.05)。治疗后,试验组的总有效率为95.35%,显著高于对照组的80.00%(P<0.05)。试验组的药物不良反应主要有恶心、腹痛、头晕、肌肉无力,对照组的药物不良反应主要有出血、恶心、呕吐、腹泻。试验组和对照组的总药物不良反应发生率分别为18.60%和20.00%,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,较大的LAAV为心房颤动术后复发影响心功能的独立危险因素(P<0.05)。结论左心耳容积及他汀类药物对心房颤动患者射频消融术后心功能均有一定影响,患者术后可服用他汀类药物改善心功能,且对于左心耳容积较大患者进行针对性治疗,以减少术后复发。Objective To observe the clinical study of left atrial appendage volume and statins on cardiac function after radiofrequency ablation of atrial fibrillation.Methods Patients who successfully completed radiofrequency ablation of atrial fibrillation were randomly divided into control group and treatment group,and were divided into recurrent group and non recurrent group based on the recurrence rate at 1months after surgery.The control group was treated with 5 mg of warfarin anticoagulant therapy after surgery,qd;the treatment group was given rosuvastatin(10 mg)or atorvastatin(20 mg)orally after surgery,qd,and both groups were treated for one month.The levels of inflammatory indexes[interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)],blood lipid indexes[total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],cardiac function indexes[left atrial ejection fraction(LAEF),A peak,left atrial maximum strain value,left atrial volume(LAV),left atrial appendage volume(LAAV)]were compared between the two groups.Results A total of 88 patients were enrolled in this trial,including 45 in the control group and 43 in the treatment group.One months after ablation,the serum IL-6 levels in the treatment group and control group were(6.27±1.24)and(12.06±1.13)ng·L^(-1),respectively;the serum hs CRP levels were(1.42±0.37)and(9.25±0.91)ng·L^(-1),respectively;the LAEF were(59.12±1.65)%and(50.07±2.48)%,respectively;the A peak values were 69.74±1.65 and 62.49±2.67,respectively;the maximum strain values of the left atrium in the two groups were36.89±1.94 and 31.42±2.26,respectively.The above indexes in the treatment group were significantly different from those in the control group(allP<0.05).After treatment,the total effective rate of 95.35%in the treatment group was significantly higher than 80.00%in the control group(P<0.05).The main adverse drug reactions of the treatment group were nausea,abdominal pain,dizziness,and muscle weakness,while the main adverse drug

关 键 词：他汀类药物 心耳容积 心房颤动 心功能 

分 类 号：R972.6[医药卫生—药品]