摘要
目的观察胺碘酮联合磷酸肌酸钠治疗室性心律失常患者的临床效果以及对患者心功能指标和血清核转录因子κB(NF-κB)、可溶性CD40配体(CD40L)水平的影响。方法前瞻性选择2017年1月至2019年12月期间在青海省心脑血管病医院接受治疗的110室性心律失常患者,采用分层随机分组法分为对照组(n=55)和观察组(n=55),对照组单纯给予胺碘酮治疗,观察组在对照组治疗方案基础上加用磷酸肌酸钠治疗。比较2组患者治疗前、治疗2个疗程后的心功能指标和血清NF-κB、CD40L水平以及生活质量水平。观察2组患者的临床疗效和不良反应发生情况。结果治疗2个疗程后,2组患者的校正QT间期(QTc)、心率均较治疗前显著改善(P<0.05),且观察组QTc、心率[(413.9±32.3)ms、(67.6±5.9)次/min]的改善幅度大于对照组[(389.7±34.6)ms、(75.4±5.4)次/min],差异均有统计学意义(P<0.05)。治疗2个疗程后,2组患者血清NF-κB、CD40L均较治疗前显著降低(P<0.05),且观察组血清NF-κB、CD40L水平[(25.4±3.1)pg/L、(1.3±0.7)μg/L]低于对照组[(38.5±3.2)pg/L、(2.2±0.8)μg/L],差异均有统计学意义(P<0.05)。治疗2个疗程后,观察组的改良Barthel指数、生活质量综合问卷评分(GQOL-74)[(94.2±6.7)、(94.2±6.9)分]明显高于对照组[(83.9±6.6)、(80.7±7.2)分],差异均有统计学意义(P<0.05)。观察组的临床治疗总有效率(87.3%)显著高于对照组(72.7%),差异有统计学意义(P<0.05)。2组患者的不良反应发生率比较(5.5%vs 3.6%),差异无统计学意义(P>0.05)。结论胺碘酮联合磷酸肌酸钠治疗室性心律失常能够显著改善心功能指标,提高NF-κB、CD40L表达水平,提升患者的生活质量水平,提高临床疗效的同时不增加不良反应发生率,体现出较高的临床应用水平。
Objective To observe the clinical effect of amiodarone combined with sodium creatine phosphate in the treatment of patients with ventricular arrhythmia and the effect on the patients'cardiac function indexes and serum nuclear transcription factor kappa B(NF-κB),soluble CD40 ligand(CD40L)levels.Methods Patients with 110 ventricular arrhythmia who were treated in Qinghai Cardiovascular and Cerebrovascular Hospital from January 2017 to December 2019 were prospectively selected and divided into a control group(n=55)and an observation group(n=55)according to the stratified random grouping method.The control group was treated with amiodarone alone,and the observation group was treated with creatine phosphate sodium based on the treatment plan of the control group.The cardiac function indexes,serum NF-κB,CD40L levels and quality of life levels of the two groups of patients before treatment and after two courses of treatment were compared.The clinical efficacy and adverse reactions of the two groups of patients were observed.Results After 2 courses of treatment,the adjusted QT interval(QTc)and heart rate of the two groups were significantly improved compared with those before treatment(P<0.05),and the QTc and heart rate of the observation group[(413.9±32.3)ms,(67.6±5.9)times/min]were greater than those of the control group[(389.7±34.6)ms,(75.4±5.4)times/min],the differences were statistically significant(P<0.05).After 2 courses of treatment,the levels of serum NF-κB and CD40L of the two groups were significantly lower than those before treatment(P<0.05),and the levels of serum NF-κB and CD40L of the observation group[(25.4±3.1)pg/L,(1.3±0.7)μg/L]were lower than those of the control group[(38.5±3.2)pg/L,(2.2±0.8)μg/L],the differences were statistically significant(P<0.05).After 2 courses of treatment,the modified Barthel index and quality of life comprehensive questionnaire score(GQOL-74)of the observation group[(94.2±6.7),(94.2±6.9)points]were significantly higher than those of the control group[(83.9±6.6),(80.7±7.2)points],the differences were statistically significant(P<0.05).The total effective rate of clinical treatment in the observation group(87.3%)was significantly higher than that in the control group(72.7%),the difference was statistically significant(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups of patients(5.5%vs 3.6%,P>0.05).Conclusion Amiodarone combined with sodium creatine phosphate in the treatment of ventricular arrhythmia can significantly improve cardiac function indicators,increase the expression levels of NF-κB and CD40L,improve the quality of life of patients,and improve clinical efficacy without increasing the incidence of adverse reactions.High level of clinical application.
作者
张生红
朱芳一
马颖
ZHANG Sheng-hong;ZHU Fang-yi;MA Ying(Department of Arrhythmia,Qinghai Cardiovascular and Cerebrovascular Hospital,Xining Qinghai 810000,China.)
出处
《临床和实验医学杂志》
2021年第18期1948-1951,共4页
Journal of Clinical and Experimental Medicine
基金
青海省自然科学基金项目(编号:2018010319)。
