于璠.沙库巴曲缬沙坦改善持续性心房颤动射频消融术后心脏结构与功能[J].内科急危重症杂志,2022,28(6):482-486
扫码阅读全文
|
| DOI：10.11768/nkjwzzzz20220611 |
| 中文关键词: 持续性心房颤动 射频消融术 沙库巴曲缬沙坦 左心房直径 |
| 英文关键词: |
| 基金项目:烟台市科技创新发展计划（No:2022YD035） |
|
| 摘要点击次数: 793 |
| 全文下载次数: 1147 |
| 中文摘要: |
| 摘要 目的：观察沙库巴曲缬沙坦（ARNI）对持续性心房颤动（简称房颤）射频消融（RFCA）术后左心房结构、心脏收缩功能及术后复发的影响。方法：选取首次行RFCA的持续性房颤患者80例，随机分为观察组和对照组，对照组给予常规抗凝、抗心律失常治疗，观察组在此基础上口服ARNI6个月。比较2组术后房颤复发率、血压、左心房直径（LAD）及左室射血分数（LVEF）。结果：2组患者术后血压比较，差异无统计学意义（P＞0.05）。术后6个月，观察组LAD小于对照组，LVEF大于对照组（P均＜0.05）；而术后3个月比较，差异无统计学意义（P均＞0.05）。术后6个月，观察组复发率低于对照组（P＜0.05）。房颤未复发组患者较复发组病程更短、LAD更小，且服用ARNI的患者比例更高。多因素Cox回归分析显示，LAD (HR=1.086，95%CI: 1.004~1.174，P=0.040)和病程(HR=1.010，95%CI: 1.003~1.017，P=0.007)是影响房颤复发的独立危险因素，口服ARNI对房颤复发无显著影响。结论：ARNI可减小持续性房颤RFCA术后LAD，并提高LVEF；且口服6个月改善较果较3个月更显著。 |
| 英文摘要: |
| Abstract Objective: To observe the effects of sacubitril/valsartan(ARNI) on left atrial structure, cardiac function and recurrence rate after radiofrequency ablation (RFCA) for the patients with persistent atrial fibrillation. Methods: Totally, 80 patients with persistent atrial fibrillation who received RFCA for the first time were randomly assigned to observation group and control group. The control group observation group were treated with oral anticoagulants and antiarrhythmic drugs, and the observation group was additionally treated with ARNI for six months. The recurrent rate of atrial fibrillation, blood pressure, left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) were compared between the groups. Results: There was no significant difference in postoperative blood pressure between the groups (P＞0.05). After six months of operation, the observation group had lower LAD and higher LVEF than control group (P＜0.05); But after three months of operation, there was no significant difference (P> 0.05). After six months of operation,the recurrence rate of observation group was lower than control group (P< 0.05) . The patients with atrial fibrillation in the non-recurrent group had shorter course of disease, lower LAD, and higher proportion of taking ARNI than recurrent group. Cox multivariate analysis showed that LAD (HR=1.086, 95%CI: 1.004-1.174, P=0.040) and course of disease (HR=1.010, 95%CI: 1.003-1.017, P=0.007) were independent risk factors for recurrence of atrial fibrillation, and taking ARNI had no significant effect on recurrence. Conclusion: Taking ARNI can decrease LAD and improve LVEF after RFCA for the patients with persistent atrial fibrillation; and taking ARNI for 6 months after RFCA improved LVEF and decreased LAD more significantly than that for 3 months. |
|
|
|
|
