厄贝沙坦联用胺碘酮治疗对阵发性心房颤动患者血清炎症因子及心肌酶NT-proBNP水平的影响
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摘要
目的:分析厄贝沙坦联用胺碘酮治疗对阵发性心房颤动患者血清炎症因子及心肌酶、氨基末端B型钠尿肽前体(NT-proBNP)水平的影响。方法:90例阵发性心房颤动患者按入院顺序编号后以简单随机数字表法随机分为观察组、对照组各45例,对照组予以常规治疗及胺碘酮,观察组采用厄贝沙坦+胺碘酮治疗,均随访12个月,记录两组心房颤动发作次数、窦性心律维持率、心功能[左室射血分数(LVEF)、左室舒张末期内径(LVDD)、左心室后壁厚度(LVPW)、P波离散度(PD)]、血清炎症因子、心肌酶谱[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)]、NT-proBNP水平及不良事件发生率。结果:观察组治疗6个月、12个月后心房颤动发作次数少于对照组,而窦性心律维持率高于对照组(P<0.05);治疗结束,观察组LVEF高于对照组,LVDD、LVPW、PD小于对照组(P<0.05);观察组治疗后血清HSP27、hs-CRP、IL-6、CK-MB、cTnI、NT-proBNP水平均低于对照组(P<0.01);观察组不良事件发生率24.44%较对照组17.78%略高,但差异无统计学意义(P>0.05)。结论:厄贝沙坦与胺碘酮联合应用可明显减少阵发性心房颤动患者心房颤动发作次数,提高窦性心律维持率、心功能,减少炎症因子及NT-proBNP水平,使心肌酶谱恢复正常,且安全可靠,值得在临床推广实践。
Objective:To analyze the effects of irbesartan combined with amiodarone on the levels of serum inflammatory factors, myocardial enzymes and amino terminal B-type N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with paroxysmal atrial fibrillation. Methods:90 patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group according to the simple random number table method after numbering with admission sequence, 45 cases in each group. The control group was given routine treatment and amiodarone, the observation group was given irbesartan combined with amiodarone treatment. The followed-up last for 12 months in both groups. The number of atrial fibrillation, maintenance rate of sinus rhythm, cardiac function [left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVDD), left ventricular posterior walldepth(LVPW), P wave dispersion(PD)], serum inflammatory factors, myocardial enzymes [Creatine kinase isoenzyme(CK-MB), cardiac troponin I(cTnI)], NT-proBNP levels and incidence of adverse events in the two groups were recorded. Results:The number of atrial fibrillation in the observation group was less than that in the control group at 6 months and 12 months after treatment, while the maintenance rate of sinus rhythm was higher than that in the control group(P<0.05). At the end of treatment, the LVEF in the observation group was higher than that in the control group, while the LVDD, LVPW and PD were smaller than those in the control group(P<0.05). The levels of serum HSP27, hs-CRP, IL-6, CK-MB, cTnI and NT-proBNP in the observation group were lower than those in the control group after treatment(P<0.01). The incidence of adverse events in the observation group was 24.44%, slightly higher than that in the control group(17.78%)(P>0.05). Conclusion: The combination application of irbesartan combined with amiodarone for patients with paroxysmal atrial fibrillation can significantly reduce the number of atrial fibrillation, improve maintenance rate of sinus rhythm and cardiac function, reduce the levels of inflammatory factors and NT-proBNP, restore myocardial enzymes to normal. It is safe and reliable.
Objective:To analyze the effects of irbesartan combined with amiodarone on the levels of serum inflammatory factors, myocardial enzymes and amino terminal B-type N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with paroxysmal atrial fibrillation. Methods:90 patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group according to the simple random number table method after numbering with admission sequence, 45 cases in each group. The control group was given routine treatment and amiodarone, the observation group was given irbesartan combined with amiodarone treatment. The followed-up last for 12 months in both groups. The number of atrial fibrillation, maintenance rate of sinus rhythm, cardiac function [left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVDD), left ventricular posterior walldepth(LVPW), P wave dispersion(PD)], serum inflammatory factors, myocardial enzymes [Creatine kinase isoenzyme(CK-MB), cardiac troponin I(cTnI)], NT-proBNP levels and incidence of adverse events in the two groups were recorded. Results:The number of atrial fibrillation in the observation group was less than that in the control group at 6 months and 12 months after treatment, while the maintenance rate of sinus rhythm was higher than that in the control group(P<0.05). At the end of treatment, the LVEF in the observation group was higher than that in the control group, while the LVDD, LVPW and PD were smaller than those in the control group(P<0.05). The levels of serum HSP27, hs-CRP, IL-6, CK-MB, cTnI and NT-proBNP in the observation group were lower than those in the control group after treatment(P<0.01). The incidence of adverse events in the observation group was 24.44%, slightly higher than that in the control group(17.78%)(P>0.05). Conclusion: The combination application of irbesartan combined with amiodarone for patients with paroxysmal atrial fibrillation can significantly reduce the number of atrial fibrillation, improve maintenance rate of sinus rhythm and cardiac function, reduce the levels of inflammatory factors and NT-proBNP, restore myocardial enzymes to normal. It is safe and reliable.
引文
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[4] 张承中.厄贝沙坦配合胺碘酮对慢性心力衰竭合并阵发性房颤患者P波最大时限及P波离散度的影响[J].解放军预防医学杂志,2016,34(4):308.
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[7] 郑宏健,祝长芝.厄贝沙坦联合胺碘酮对慢性心力衰竭患者P波离散度与阵发性心房颤动的影响[J].心脑血管病防治,2017,17(3):182～184.
[8] 王苗苗.胺碘酮联合厄贝沙坦治疗老年CHF伴阵发性心房颤动的效果观察[J].中西医结合心脑血管病杂志,2018,16(13):1848～1851.
[9] 李麟,王永莉,曹佳宁,等.依那普利联合胺碘酮治疗阵发性心房颤动效果观察[J].人民军医,2016,59(1):36～37.
[2] Lamberts M,Lip GY,Ruwald MH,et al.Antithrombotic treatment in patients with heart failure and associated atrial fibrillation and vascular disease:a nation wide cohort study[J].Am Coll Cardiol,2014,63(24):2689～2698.
[3] 刘寿东.厄贝沙坦氢氯噻嗪联用胺碘酮对持续性房颤转复后维持窦性心律的影响[J].现代中西医结合杂志,2014,23(14):1538～1540.
[4] 张承中.厄贝沙坦配合胺碘酮对慢性心力衰竭合并阵发性房颤患者P波最大时限及P波离散度的影响[J].解放军预防医学杂志,2016,34(4):308.
[5] 韩晓霞,郭庆玲,冯巧飞,等.1例甲亢并发极快速型房颤患者的护理[J].标记免疫分析与临床,2016,23(5):590～591.
[6] 卢红艳,宁伟明,苏新养,等.血清CRP、Fib及NT-proBNP对慢性房颤并发早期心衰的诊断价值[J].海南医学,2017,27(8):1271～1273.
[7] 郑宏健,祝长芝.厄贝沙坦联合胺碘酮对慢性心力衰竭患者P波离散度与阵发性心房颤动的影响[J].心脑血管病防治,2017,17(3):182～184.
[8] 王苗苗.胺碘酮联合厄贝沙坦治疗老年CHF伴阵发性心房颤动的效果观察[J].中西医结合心脑血管病杂志,2018,16(13):1848～1851.
[9] 李麟,王永莉,曹佳宁,等.依那普利联合胺碘酮治疗阵发性心房颤动效果观察[J].人民军医,2016,59(1):36～37.