摘要
目的:基于心血管不良事件、复发率,探讨益生菌辅助沙库巴曲缬沙坦+胺碘酮对心房颤动射频消融术(RFCA)后患者近远期疗效的影响。方法:选取2021年6月至2022年6月该院收治的行RFCA术心房颤动患者90例,根据治疗方案的不同分为对照组、观察组和益生菌组,各30例。对照组患者给予胺碘酮,观察组患者给予沙库巴曲缬沙坦+胺碘酮,益生菌组患者给予益生菌辅助沙库巴曲缬沙坦+胺碘酮,比较三组患者不同时间(治疗前,治疗3、6和12个月后)心房结构指标[左心房内径(LAD)、左心房容积指数(LAVI)、左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)、二尖瓣返流面积(MRA)和左心室收缩末期容积指数(LVESVI)]、心肌纤维化指标[可溶性生长刺激表达基因2蛋白(sST2)、半乳凝素-3(Gal-3)]、神经内分泌因子[血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]和肠道菌群代谢产物[总胆汁酸、氧化三甲胺(TMAO)]水平,以及不良反应、近远期心血管不良事件和复发情况。结果:治疗3、6和12个月后,益生菌组患者的LAD、LAVI、MRA、LVEDVI和LVESVI水平低于观察组、对照组,LVEF水平高于观察组、对照组,血清sST2、Gal-3、AngⅡ和NE水平低于观察组、对照组,差异均有统计学意义(P<0.05)。治疗3、6和12个月后,益生菌组患者的血清总胆汁酸、TMAO水平较治疗前降低,且低于观察组、对照组,差异均有统计学意义(P<0.05)。三组患者头晕恶心、低血压、咳嗽和肝功能异常等不良反应发生率比较,差异均无统计学意义(P>0.05);益生菌组患者的远期复发率低于观察组、对照组,差异有统计学意义(P<0.05)。结论:益生菌辅助沙库巴曲缬沙坦+胺碘酮应用于心房颤动RFCA术后,有利于改善患者心房结构与心肌纤维化,调节神经内分泌激素、肠道菌群代谢产物,减少RFCA术后远期复发。
OBJECTIVE:To probe into the effects of probiotic-assisted sakubactril valsartan + amiodarone on short and long term efficacy of atrial fibrillation after radiofrequency ablation(RFCA) based on cardiovascular adverse events and recurrence rate.METHODS:A total of 90 patients with atrial fibrillation undergoing RFCA from Jun.2021 to Jun.2022 were extracted to be divided into the control group,observation group and probiotic group according to different treatment regimens,with 30 cases in each group.The control group was given amiodarone,while the observation group received sackubactril valsartan + amiodarone,and the probiotic group was treated with probiotic-assisted sakubactril valsartan + amiodarone.The atrial structure indicators [left atrial diameter(LAD),left atrial volume index(LAVI),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume index(LVEDVI),mitral regentation area(MRA),left ventricular end-systolic volume index(LVESVI)],myocardial fibrosis indicators [soluble growth stimulation gene 2 protein(sST2),galactogenin-3(Gal-3)],neuroendocrine factors [angiotensin Ⅱ(AngⅡ),norepinephrine(NE)],intestinal microbiota metabolites [total bile acid,trimethylamine oxide(TMAO)],adverse drug reactions,short and long term cardiovascular adverse events,recurrence rate were compared among three groups at different time points(before treatment,after treatment of 3 months,6 months and 12 months).RESULTS:After treatment of 3 months,6 months and 12 months,LAD,LAVI,MRA,LVEDVI and LVESVI in probiotic group were lower than those in observation group and control group,and LVEF was higher than those in observation group and control group,serum sST2,Gal-3,AngⅡ and NE levels in probiotic group were lower than those in observation group and control group,with statistically significant differences(P<0.05).Serum total bile acid and TMAO levels in probiotic group after treatment of 3 months,6 months and 12 months were lower than those before treatment,and the probiotic group was lower than the observation
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(Dept.of Cardiology,the First Hospital of Zhangjiakou,Hebei Zhangjiakou 075000,China;Dept.of Health Management,the First Hospital of Zhangjiakou,Hebei Zhangjiakou 075000,China)
出处
《中国医院用药评价与分析》
2024年第1期33-37,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
2023年度河北省医学科学研究课题计划(No.20232068)。
关键词
益生菌
心房颤动
射频消融术
沙库巴曲缬沙坦
胺碘酮
Probiotics
Atrial fibrillation
Radiofrequency ablation
Sacubatrol valsartan
Amiodarone
