目的:探讨中医药干预对慢性心力衰竭合并心房颤动患者近期心功能和远期预后的影响。方法:采用队列研究设计、倾向评分匹配(PSM)进行精确比较。使用医院病案管理系统提取患者信息、随访药物使用和终点事件发生情况。比较暴露组与非暴露...目的:探讨中医药干预对慢性心力衰竭合并心房颤动患者近期心功能和远期预后的影响。方法:采用队列研究设计、倾向评分匹配(PSM)进行精确比较。使用医院病案管理系统提取患者信息、随访药物使用和终点事件发生情况。比较暴露组与非暴露组治疗前后NYHA心功能分级、LVEF、NT-proBNP改变和心衰再入院、心源性死亡发生情况。Kaplan-Meier生存分析、Cox生存分析探讨中医药干预与心衰再入院、心源性死亡的关系。结果:共检索到符合要求患者959例,成功随访842例,倾向评分匹配成功771例。治疗前后暴露组和非暴露组NYHA分级、LVEF、NT-proBNP改善值分别为0.70 vs 0.58、8.15%vs 6.74%、1038pg/mL vs 942pg/mL。PSM前和PSM后,暴露组心衰再入院率及心源性死亡率均显著低于非暴露组(P<0.01)。Kaplan-Meier生存分析表明,暴露组在相同随访时间点心衰再入院率和心源性死亡率低于非暴露组,暴露组生存率显著高于非暴露组(P<0.01)。Cox生存分析表明,中医药干预是心衰再入院和心源性死亡的保护因素。结论:西医常规疗法联合中医药干预能够更好地改善慢性心力衰竭合并心房颤动患者的心功能,降低心衰再入院率和心源性死亡率,改善近期和远期预后。展开更多
Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preven...Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0<sup>th</sup>, 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a pr展开更多
文摘目的:探讨中医药干预对慢性心力衰竭合并心房颤动患者近期心功能和远期预后的影响。方法:采用队列研究设计、倾向评分匹配(PSM)进行精确比较。使用医院病案管理系统提取患者信息、随访药物使用和终点事件发生情况。比较暴露组与非暴露组治疗前后NYHA心功能分级、LVEF、NT-proBNP改变和心衰再入院、心源性死亡发生情况。Kaplan-Meier生存分析、Cox生存分析探讨中医药干预与心衰再入院、心源性死亡的关系。结果:共检索到符合要求患者959例,成功随访842例,倾向评分匹配成功771例。治疗前后暴露组和非暴露组NYHA分级、LVEF、NT-proBNP改善值分别为0.70 vs 0.58、8.15%vs 6.74%、1038pg/mL vs 942pg/mL。PSM前和PSM后,暴露组心衰再入院率及心源性死亡率均显著低于非暴露组(P<0.01)。Kaplan-Meier生存分析表明,暴露组在相同随访时间点心衰再入院率和心源性死亡率低于非暴露组,暴露组生存率显著高于非暴露组(P<0.01)。Cox生存分析表明,中医药干预是心衰再入院和心源性死亡的保护因素。结论:西医常规疗法联合中医药干预能够更好地改善慢性心力衰竭合并心房颤动患者的心功能,降低心衰再入院率和心源性死亡率,改善近期和远期预后。
文摘Background: Atrial fibrillation commonly occurs following cardiac surgery, particularly after coronary artery bypass grafting. Magnesium, known for its stabilizing effect on cell membranes, has shown promise in preventing postoperative atrial fibrillation. This study aimed to assess the impact of intravenous magnesium infusion in preventing atrial fibrillation after off-pump coronary artery bypass grafting, where maintaining stable cell membranes is crucial in averting this complication. Methods: A cross-sectional study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, from March 2020 to February 2022. Sixty-six patients who underwent off-pump coronary artery bypass grafting were enrolled and divided into two groups. Group A (n = 33) received intravenous magnesium sulfate (10 mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the Intensive Care Unit (ICU) within three days after surgery was evaluated using convenient sampling. Statistical analysis was performed with SPSS version 26.0, utilizing independent Student’s t-test for continuous data and Chi-square and Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered statistically significant. Results: No significant differences in age or gender were observed between the two groups. Group B exhibited significantly lower magnesium levels than Group A on the 0<sup>th</sup>, 1<sup>st</sup>, 2<sup>nd</sup>, and 3<sup>rd</sup> days post-surgery. Additionally, Group B experienced a higher incidence of postoperative atrial fibrillation, longer ICU stays, and two mortalities. The study did not detect any adverse effects associated with magnesium infusion. Conclusion: It has been demonstrated that administering magnesium intravenously after off-pump coronary artery bypass grafting can lower the chances of developing atrial fibrillation. This demonstrates the potential advantages of using magnesium as a pr
