沙库巴曲缬沙坦联合胺碘酮对首次行射频消融术的持续性心房颤动老年患者左心房结构及成纤维细胞生长因子23、内皮素-1水平的影响  

Effects of Sacubitril Valsartan Combined with Amiodarone on Left Atrial Structure and Levels of Fibroblast Growth Factor 23 and Endothelin-1 in Elderly Patients with Persistent Atrial Fibrillation Undergoing First Radiofrequency Catheter Ablation

作　　者：孙飞 周倩[1] 吴晓倩 石运忠 陈珂 SUN Fei;ZHOU Qian;WU Xiao-qian;SHI Yun-zhong;CHEN Ke(Department I of Cardiology,Zhoukou Central Hospital,Zhoukou 466000,China;Ward II of Arrhythmia Disease,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451460,China)

机构地区：[1]河南省周口市中心医院心内一科,周口466000 [2]阜外华中心血管病医院心律失常二病区,郑州451460

出　　处：《中国合理用药探索》2025年第3期62-68,共7页Chinese Journal of Rational Drug Use

基　　金：2020年度河南省医学科技攻关计划联合共建项目(LHGJ20200080)。

摘　　要：目的:探讨沙库巴曲缬沙坦联合胺碘酮对首次行射频消融术(RFCA)的持续性心房颤动老年患者左心房结构及成纤维细胞生长因子23、内皮素-1水平的影响。方法:选取2021年4月~2024年4月期间于某院接受RFCA治疗的110例持续性心房颤动老年患者作为研究对象,采用随机数字表法分为对照组和观察组,每组55例。对照组患者给予盐酸胺碘酮片治疗,观察组患者在对照组治疗基础上加用沙库巴曲缬沙坦钠片,共服用6个月。比较两组左心房结构指标(左心房内径、左心房容积、左室收缩末容积指数、左室舒张末容积指数、左心室射血分数)、心率震荡指标(震荡初始值、震荡斜率、震荡时域分析指标)、心肌纤维化指标(可溶性生长刺激表达基因2蛋白、半乳凝素-3)、内皮素-1、成纤维细胞生长因子23、内皮源性一氧化氮水平、临床疗效及不良反应发生情况。结果:治疗后,两组患者左心房内径、左心房容积、左室收缩末容积指数和左室舒张末容积指数均降低(P<0.05),且观察组低于对照组(P<0.05);左心室射血分数、震荡初始值、震荡斜率和震荡时域分析指标均升高(P<0.05),且观察组高于对照组(P<0.05);可溶性生长刺激表达基因2蛋白、半乳凝素-3、内皮素-1和成纤维细胞生长因子23水平均降低(P<0.05),且观察组低于对照组(P<0.05);内皮源性一氧化氮水平升高(P<0.05),且观察组高于对照组(P<0.05);观察组患者治疗总有效率(94.55%)高于对照组(81.82%,P<0.05)。两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:沙库巴曲缬沙坦联合胺碘酮治疗首次行RFCA的持续性心房颤动老年患者效果较佳,可有效改善患者左心房结构、心肌纤维化、血管内皮功能,且不会增加不良反应的发生率。Objective:To investigate the effects of sacubitril valsartan combined with amiodarone on left atrial structure and levels of fibroblast growth factor 23 and endothelin-1 in elderly patients with persistent atrial fibrillation undergoing first radiofrequency catheter ablation(RFCA).Methods:A total of 110 elderly patients with persistent atrial fibrillation who received RFCA treatment in a hospital during April 2021 to April 2024 were selected and divided into the control group and the observation group using the random number table method,with 55 patients in each group.The control group was treated with amiodarone hydrochloride tablets,while the observation group was treated with sacubitril valsartan sodium tablets in addition to the control treatment,for a total of 6 months.The left atrial structure indexes(left atrial diameter,left atrial volume,left ventricular end-systolic volume index,left ventricular end-diastolic volume index,left ventricular ejection fraction),heart rate turbulence indexes(turbulence onset,turbulence slope,turbulence time domain analysis index),myocardial fibrosis indexes(soluble suppression of tumorigenicity 2 protein,galectin-3),endothelin-1,fibroblast growth factor 23,endothelium-derived nitric oxide level,clinical efficacy and adverse reactions were compared between the two groups.Results:After treatment,left atrial diameter,left atrial volume,left ventricular end-systolic volume index and left ventricular end-diastolic volume index were decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).Left ventricular ejection fraction,onset,slope and time domain analysis results of turbulence were increased in both groups(P<0.05),and higher in the observation group than in the control group(P<0.05).The levels of soluble suppression of tumorigenicity 2 protein,galectin-3,endothelin-1 and fibroblast growth factor 23 were decreased in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).The level of endothelium-deri

关 键 词：沙库巴曲缬沙坦 射频消融术 持续性心房颤动 左心房结构 成纤维细胞生长因子23 内皮素-1 

分 类 号：R541.75[医药卫生—心血管疾病]