益生菌联合沙库巴曲缬沙坦及胺碘酮对心房颤动射频消融术后近期与远期疗效的影响  

Effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofrequency ablation

作　　者：张明婷 毛建云 席建芬 韩文杰 李卓琪 赵东坡 ZHANG Mingting;MAO Jianyun;XI Jianfen;HAN Wenjie;LI Zhuoqi;ZHAO Dongpo(Department of Cardiology,the First Hospital of Zhangjiakou City in Hebei Province,Zhangjiakou,Hebei,075000;Department of Health Management,the First Hospital of Zhangjiakou City in Hebei Province,Zhangjiakou,Hebei,075000)

机构地区：[1]河北省张家口市第一医院心内科,河北张家口075000 [2]河北省张家口市第一医院健康管理科,河北张家口075000

出　　处：《实用临床医药杂志》2024年第9期45-51,共7页Journal of Clinical Medicine in Practice

基　　金：2023年度河北省医学科学研究课题(20232068)。

摘　　要：目的 探讨益生菌联合沙库巴曲缬沙坦及胺碘酮对心房颤动(简称房颤)射频消融术后近期及远期疗效的影响。方法 将2021年6月—2022年6月张家口市第一医院收治的90例房颤射频消融术后患者随机分为3组,每组30例。对照组采用胺碘酮治疗,沙库巴曲缬沙坦组采用胺碘酮及沙库巴曲缬沙坦治疗,益生菌组采用益生菌联合胺碘酮及沙库巴曲缬沙坦治疗。比较3组复发情况、心房结构指标[左心房内径(LAD)、左心室射血分数(LVEF)、左室收缩末期容积指数(LVESVI)、左心房容积(LAV)、左室舒张末期容积指数(LVEDVI)]、心肌纤维化指标[半乳凝素-3(Gal-3)、可溶性生长刺激表达基因2蛋白(sST2)]、炎症反应指标[细胞间黏附分子-1(ICAM-1)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]、神经内分泌激素指标[醛固酮、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)]、肠道菌群代谢产物[总胆汁酸、氧化三甲胺(TMAO)]及不良事件发生率。结果 治疗后12个月,益生菌组复发率低于沙库巴曲缬沙坦组、对照组,差异有统计学意义(P<0.05);治疗3、6、12个月后,益生菌组LAD、LAV、LVESVI、LVEDVI、sST2、Gal-3低于沙库巴曲缬沙坦组、对照组,沙库巴曲缬沙坦组上述指标低于对照组,差异均有统计学意义(P<0.05);治疗3、6、12个月后,益生菌组LVEF高于沙库巴曲缬沙坦组、对照组,沙库巴曲缬沙坦组LVEF高于对照组,差异有统计学意义(P<0.05);治疗3、6、12个月后,益生菌组CRP、IL-6、ICAM-1、NE、醛固酮、AngⅡ低于沙库巴曲缬沙坦组、对照组,沙库巴曲缬沙坦组上述指标低于对照组,差异有统计学意义(P<0.05);治疗3、6、12个月后,益生菌组TMAO、总胆汁酸低于对照组、沙库巴曲缬沙坦组,差异有统计学意义(P<0.05);3组不良事件发生率比较,差异无统计学意义(P>0.05)。结论 益生菌联合沙库巴曲缬沙坦、胺碘酮可改善房颤射频消融术后心房结构,抑制Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofrequency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly divided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial structure indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion molecule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone indexes[aldosterone,norepinephrine(NE),angiotensinⅡ(AngⅡ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P<0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P<0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P<0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the control group(P<0.05),and the LVEF of the sacubitril

关 键 词：益生菌 沙库巴曲缬沙坦 胺碘酮 心房颤动 射频消融术 复发 

分 类 号：R541.7[医药卫生—心血管疾病] R454[医药卫生—内科学] R37[医药卫生—临床医学]