决奈达隆治疗阵发性心房颤动抗凝患者的疗效和安全性观察  

The Clinical Efficacy and Safety of Dronedarone in the Combined Treatment of Paroxysmal Atrial Fibrillation Patients with Edoxaban

作　　者：陈鑫 王钰 郑齐锶 赵英明 CHEN Xin;WANG Yu;ZHENG Qisi;ZHAO Yingming(Department of Cardiology,Gulou Hospital,Jiangsu 210001,China;Department of Clinical Laboratory Medicine,Gulou Hospital,Jiangsu 210001,China)

机构地区：[1]江苏省南京鼓楼医院心血管内科,江苏南京210001 [2]江苏省南京鼓楼医院检验科,江苏南京210001

出　　处：《转化医学杂志》2024年第5期816-819,共4页Translational Medicine Journal

基　　金：教育部重点实验室开放性课题(编号:EKLMIC202404)。

摘　　要：目的评价决奈达隆治疗阵发性心房颤动(以下简称房颤)患者的临床疗效及对患者血清超敏C反应蛋白(hs-CRP)和N末端B型脑钠肽前体(NT-proBNP)水平的影响。方法选择2024年1月至2024年4月江苏省南京鼓楼医院心血管内科收治的阵发性房颤且抗凝的患者60例,按照随机数字表法分为对照组和治疗组,每组30例。2组患者均给予标准的房颤心率和抗凝管理,治疗组在标准房颤心率和抗凝管理药物治疗基础上联合使用决奈达隆400 mg,每日2次,2组均治疗15周。比较2组治疗后症状性房颤发生率,比较2组治疗前后动态心电图平均心率和房颤心律占比及血浆hs-CRP、NT-proBNP水平,并检测2组安全性。结果治疗组、对照组症状性房颤事件发生率分别为10.00%和20.00%,治疗组显著低于对照组(P<0.05)。治疗后,2组平均心率和房颤心律占比均较治疗前明显降低(P<0.05),且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,2组血浆NT-proBNP、hs-CRP水平较本组治疗前显著降低(P<0.05),且治疗组治疗后NT-proBNP和hs-CRP水平均低于对照组(P<0.05)。治疗组在研究过程中未见严重不良反应。结论决奈达隆在规范抗凝治疗基础上治疗阵发性房颤患者疗效显著,并且可进一步控制患者节律及血清hs-CRP、Nt-proBNP水平,安全性良好。Objective To evaluate the clinical efficacy of dronedarone combined with edoxaban and investigate its effect on the dynamic electrocardiogram(Holter),high-sensitivity C-reactive protein(hsCRP),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels in patients with paroxysmal atrial fibrillation undergoing anticoagulant therapy.Methods Sixty patients with paroxysmal atrial fibrillation requiring anticoagulation were randomly divided into two groups.The control group(n=30)received standard heart rate and anticoagulation management,while the treatment group(n=30)received additional dronedarone(400 mg bid)on the basis of standard therapy.Both groups were treated for 15 weeks.The frequency of atrial fibrillation attacks,improvement in Holter indicators,and serum levels of hsCRP and NT-proBNP were compared before and after treatment.Results After treatment,the improvement rates of atrial fibrillation events were 71.5%in the control group and 86.6%in the treatment group,with the treatment group showing significantly better improvement(P<0.05).Both groups showed significant improvement in Holter indicators after treatment(P<0.05),with the treatment group demonstrating superior improvements compared to the control group(P<0.05).Serum levels of NT-proBNP and hsCRP were significantly reduced in both groups after treatment(P<0.01),and the treatment group achieved further reductions compared to the control group(P<0.05).No serious adverse events were observed in either group during the study period.Conclusion On the basis of standard anticoagulation therapy,dronedarone shows significant efficacy in the treatment of paroxysmal atrial fibrillation,effectively controlling cardiac rhythm,reducing hsCRP and NT-proBNP levels,and decreasing the risk of cardiovascular events.

关 键 词：决奈达隆 艾多沙班 心房颤动 动态心电图 超敏C反应蛋白 B型氨基端利钠肽原(NT-proBNP) 

分 类 号：R541.61[医药卫生—心血管疾病]