摘要
目的：评价风湿性心脏病二尖辫狭窄合并心房颤动在PBMV术后控制心律和心率对患者预后的影响。方法：选择风湿性心脏病二尖辫狭窄合并房颤PBMV术后的患者347例为观察对象，分为控制心律组164例，其中男68例，女96例，年龄17～58岁，平均37．7±9．8岁，房颤病史6个月-11年，平均5．9±3．7年，直流电转复心律，采用100～300J，平均158．6±36．8J的能量，应用口服胺碘酮维持窦性心律；控制心率组183例，其中男72例，女111例，年龄18～64岁，平均39．2±11．3岁，房颤病史6个月-12年，平均6．2±3．9年，应用口服地高辛，β-阻滞剂或钙拮抗剂控制心率，华法令持续抗凝。观察两组间再住院率、不良事件发生率的差别。结果：心律控制组有56例病人在随访期间再住院1—2次，平均1．2±0．4次，再住院率为34，1％，有1例死亡，8例出现脑栓塞，不良事件发生5．5％，口服胺腆酮未出现药物毒副反应。心率控制组有108例再次住院，住院次数1～3．次，平均1．6±0．9次，再住院率为59.0％，有2例死亡，28例出现脑栓塞，3例出现下肢栓塞，1例出现肠系膜上动脉栓塞，不良事件发生率18．6%，服药期间有67例出现轻度的出血症状，二组在再住院率方面比较P〈0．05，有显著性差异，不良事件发生率二者比较P〈0．01，有非常显著性差异。结论：对于风湿性心脏病二尖辫狭窄合并房颤在PBMV术后控制心律比控制心率在病人再住院率、不良事件发生率方面具有明显优越性，更好地改善病人的预后。
Objective： To evaluate the effect of prognosis about rhythm - control and rate - control in rheumatic heart disease patients after PBMV with AF. Method： A total of 347 mitrals stenosis patients after PBMV with AF were select as object of observation. The patients were divided into two groups. Rhythm control had 164 patients, males 68, females 96, who were 17 ± 58 years old mean 37.7 ± 9.8 years old, AF histroy were from 6 months to 11 years, mean 5.9 ± 3.7 years. To maintain sinus rhythm after sucessful electric cardiversion with 100 - 300J by oral amiodarone, mean 158.6 ± 36.8 ; Rate - control group had 183 patients, males 72, females 111, who were 18 ± 64 years old, mean 39.2 ± 11.3 years, AF histroy were from 6 months to 12 years, mean 6.2 ± 3.9 years. To maintain rate by oral Digoxin , β -blocker or calcium channel blocker. Warfarin was used for anticoagulation, Observe the difference of rate of rehospitalization and bad events between the two groups. Result： The number of rehospitalization were 1 ± 2 times for 56 patiens in rhythm control group, mean 1.2 ± 0.4 times, The rate of rehospitalization were 34.1% . One patient died, cerebral embolism in 8 patients ,The rate of bad events were 5.5%. Adverse reaction of drug did not emerge by oral amiodarone. The number of rehospitalization were 1 ± 3 times for 108 patients in rate - control group, mean 1. 6 ± 0.9 times, The rates of rehospitalization were 59.0%. Two patients died, Cerebral embolism in 28 patients,lower limbs embolism in 3 patients, arteria mesenterica superior embolism in 1 patient. The rate of bad events were 18.6% ,67 patients emerged slight syptom. There was significant difference with the rate of rehospitalization and bad events, between the two groups, the rates of rehospitalization P 〈 0.05, the rates of bad events P 〈 0.01. Conclusion ：The superior rate of rehospitalization and bad events was obviously for rheumatic heart disease, Patients with mitrals stenosis combined with AF, Rthym -control can improve the prognosis better than rate control.
出处
《河北医学》
CAS
2006年第10期959-962,共4页
Hebei Medicine
关键词
风心病
心房颤动
二尖瓣狭窄
PBMV术
心律
心率
Rheumatic heart diease
atrial fibrillation
Mitral stenosis
Percutaneous ballon mitral valvuloplasty（ PBMV ）
Rhythm
Heart rate
