摘要
目的研究培哚普利对阵发性心房颤动(PAF)导管射频消融术的疗效及术后复发的影响。方法选取我院收治的186例PAF患者,依据随机数字表法分为观察组和对照组,每组93例,所有患者均行环肺静脉隔离的导管射频消融治疗。观察组术后服用3个月的培哚普利,对照组给予安慰剂治疗。所有患者均随访12个月,统计并检测术后3个月、12个月快速性房性心律失常复发及心功能指标情况,比较2组患者术后3个月的血清可溶性基质裂解素2(sST2)、半乳糖凝集素3(galectin-3)水平。结果观察组术后早期复发率(6.45%vs 17.20%)、晚期复发率(10.75%vs 22.58%)均低于对照组,差异有统计学意义(P<0.05)。术后3个月、12个月观察组左心房内径显著低于对照组,LVEF显著高于对照组(P<0.05)。与术前比较,2组术后3个月sST2、galectin-3水平均显著降低(P<0.05);观察组患者术后3个月血清sST2、galectin-3水平显著低于对照组[(452.55±57.47)ng/L vs(554.74±58.18)ng/L,(1729.78±522.38)ng/L vs(1960.63±574.43)ng/L,P<0.01]。2组患者导管射频消融手术时主要不良事件(心脏压塞、迷走神经反射)发生率比较无显著差异(P>0.05)。随访过程中主要不良事件为咳嗽、呕吐,其中观察组患者咳嗽发生率高于对照组,差异有统计学意义(P<0.05)。结论培哚普利可降低PAF导管射频消融术后早期、晚期复发率,降低血清sST2、galectin-3以及改善心脏功能结构,从而提高治疗效果。
Objective To study the effect of perindopril on the efficacy and recurrence of paroxysmal AF after radiofrequency catheter ablation(RCA).Methods One hundred and eighty-six paroxysmal AF patients who underwent RCA in our hospital were divided into observation group(93)and control group(93).The patients in observation group were treated with perindopril for 3 months while those in control group were given placebo after RCA.The patients were followed up for 12 months.The recurrence of rapid atrial arrhythmia and cardiac function parameters in two groups were recorded at months 3 and 12 after RCA.The serum levels of sST2 and galectin-3 in two groups were measured at month 3 after RCA.Results The recurrence rate of early and late paroxysmal AF was significantly lower in observation group than in control group at month 3 after RCA(6.45%vs 17.20%,10.75%vs 22.58%,P<0.05).The left atrial diameter was significantly shorter while the LVEF was significantly higher in observation group than in control group at months 3 and 12 after RCA(P<0.05).The serum levels of sST2 and galectin-3 were significantly lower in two groups after RCA than before RCA(P<0.05)and in observation group than in control group at month 3 after RCA(452.55±57.47 ng/L vs 554.74±58.18 ng/L,1729.78±522.38 ng/L vs 1960.63±574.43 ng/L,P<0.01).No significant difference was detected in the incidence of major adverse events(cardiac tamponade,vagus reflex)in two groups during RCA(P>0.05).The major adverse events during the follow-up were hypokalemia,cough and vomiting.The incidence of cough was significantly higher in observation group than in control group(P<0.05).Conclusion Perindopril can reduce the recurrence rate of early and late paroxysmal AF and the serum sST2 and galectin-3 levels,and improve the cardiac functional structure after RCA,thus improving the therapeutic effect of paroxysmal AF.
作者
申玉梅
陈莉
杨士芝
刘璐
李伟华
Shen Yumei;Chen Li;Yang Shizhi;Liu Lu;Li Weihua(Department of Health Management,Jinan People's Hospital Affiliated to Shandong First Medical University,Jinan 271199,Shandong Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2020年第12期1281-1284,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
