文章摘要
瑞舒伐他汀联合胺碘酮对阵发性心房颤动患者心室重构心电图P波及外周血指标的影响
Effects of rosuvastatin combined with amiodarone on ventricular remodeling, electrocardiogram P wave and peripheral blood parameters in patients with PAF
投稿时间：2019-05-01  
DOI：10.3969/j.issn.1000-0399.2020.07.008
中文关键词: 瑞舒伐他汀  胺碘酮  阵发性心房颤动  心室重构  P波离散度
英文关键词: Rosuvastatin  Amiodarone  Paroxysmal atrial fibrillation  Ventricular remodeling  P wave dispersion
基金项目:2016年度河南省医学科技攻关计划项目（项目编号：201602155）
作者单位
张俊彪 453100 河南卫辉 新乡医学院第一附属医院心血管内科二病区 
刘辉 453100 河南卫辉 新乡医学院第一附属医院心血管内科二病区 
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中文摘要:
      目的 探究瑞舒伐他汀联合胺碘酮对阵发性心房颤动（PAF）患者心室重构、心电图P波离散度及外周血Apelin-13、转化生长因子（TGF）-β1的影响。方法 选取2017年4月至2018年4月新乡医学院第一附属医院收治的116例PAF患者为研究对象，采用随机数字表法分为治疗组和对照组，每组各58例。对照组给予口服胺碘酮治疗，治疗组在此基础上口服瑞舒伐他汀。获取治疗前、治疗12周后两组患者左房内径（LAD）、左室射血分数（LVEF）、心电图P波离散度及外周血Apelin-13、TGF-β1检测数据，随访并统计治疗后3个月、6个月、12个月窦性心律维持有效率及转归情况。结果 治疗12周后，治疗组LAD低于对照组，LVEF高于对照组，P波离散度低于对照组，且血清Apelin-13高于对照组，TGF-β1低于对照组，差异均有统计学意义（P<0.05）。治疗组治疗后LAD、LVEF、P波离散度、Apelin-13、TGF-β1差值均大于对照组，差异有统计学意义（P均<0.05）。所有患者治疗后均至少随访1年，随访率100%。治疗组治疗后3、6、12个月窦性心律维持有效率分别为94.83%、87.93%、81.03%，高于对照组的82.76%、72.14%、63.79%（P<0.05），且转为持续性心房颤动（AF）者所占比率为3.45%，低于对照组的13.79%，差异均有统计学意义（P<0.05），转为永久性AF者所占比例差异无统计学意义（P>0.05）。结论 瑞舒伐他汀联合胺碘酮治疗可有效改善PAF患者心室重构、心电图P波离散度及外周血Apelin-13、TGF-β1水平，有助于维持窦性心律及改善临床转归。
英文摘要:
      Objective To investigate the effects of rosuvastatin combined with amiodarone on ventricular remodeling, electrocardiogram P wave dispersion, peripheral blood Apelin-13 and transforming growth factor (TGF)-β1 in patients with paroxysmal atrial fibrillation (PAF). Methods From April 2017 to April 2018, 116 PAF patients admitted to the First Affiliated Hospital of Xinxiang Medical College were divided into treatment group and control group by random number table method, with 58 cases in each group. The control group was given oral amiodarone. On this basis, treatment group was additionally given oral rosuvastatin. The measurement data such as left atrial diameter (LAD), left ventricular ejection fraction (LVEF), electrocardiogram P wave dispersion, peripheral blood Apelin-13 and TGF-β1 before treatment and 12 weeks after treatment were obtained. The effective rate and prognosis of sinus rhythm maintenance 3 months, 6 months and 12 months after treatment were followed up. Results After 12 weeks of treatment, LAD in treatment group was significantly lower than that in control group, LVEF was significantly higher than that in control group, P wave dispersion was significantly lower than that in control group, and serum apelin-13 was significantly higher than that in control group, TGF-β1 was significantly lower than that in control group, and all the differences were statistically significant (P < 0.05). LAD, LVEF, P wave dispersion, apelin-13 and TGF-β1 in treatment group were higher than those in control group, and the differences were statistically significant (P < 0.05). All patients were followed up for at least 1 year after treatment, with follow-up rate of 100%. The response rate of sinus rhythm maintenance 3 months, 6 months and 12 months after treatment in treatment group was 94.83%, 87.93% and 81.03%, respectively, all significantly higher than that in control group (82.76%, 72.14% and 63.79%) (P<0.05). The proportion of patients conversing to persistent AF in treatment group was significantly lower than that in control group (3.45% vs 13.79%) (P<0.05). There was no significant difference in the proportion of patients conversing to permanent atrial fibrillation (AF) between the two groups (P>0.05). Conclusions Rosuvastatin combined with amiodarone can effectively improve ventricular remodeling, electrocardiogram P wave dispersion, peripheral blood Apelin-13 and TGF-β1 levels in PAF patients, thus helping maintain sinus rhythm and improve clinical outcomes.
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