摘要
目的探讨稳心颗粒对阵发性房颤患者窦性心律维持及心肌纤维化影响。方法选取2019年5月—2021年5月期间上海市宝山区中西医结合医院收治的阵发性房颤患者100例,采用随机信封法分为对照组和观察组,每组各50例。对照组采用盐酸胺碘酮片治疗,在此基础上观察组采用稳心颗粒治疗。评价治疗8周后两组患者用药有效性及安全性,比较两组患者治疗前及治疗后3个月心室率、PAF发作持续时间、左房功能[左室射血分数(Left ventricular ejection fraction,LVEF)和左房内径(Left atrial diameter,LAD)]及血清纤维化指标[Ⅲ型前胶原氨基末端肽(Typeⅲprocollagen amino terminal peptide,PⅢNP)、基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)]水平的变化,同时比较两组患者治疗后3个月、6个月窦性心律维持有效率。结果治疗后观察组总有效率90.00%(45/50)与对照组72.00%(36/50)比较明显升高,差异有统计学意义(P<0.05)。治疗后3个月两组患者心室率、PAF发作持续时间与治疗前比较明显减少,差异有统计学意义(P<0.05);且观察组心室率、PAF发作持续时间与对照组比较明显减少,差异有统计学意义(P<0.05)。治疗后3个月、6个月,观察组窦性心律维持有效率与对照组比较均明显升高,差异有统计学意义(P<0.05)。治疗后3个月两组患者LVEF与治疗前比较明显升高,LAD与治疗前比较明显降低,差异有统计学意义(P<0.05);且观察组LVEF与对照组比较明显升高,LAD与对照组比较明显降低,差异有统计学意义(P<0.05)。治疗后3个月两组患者血清MMP-2、PⅢNP水平与治疗前比较明显降低,差异有统计学意义(P<0.05);且观察组血清MMP-2、PⅢNP水平与对照组比较明显降低,差异有统计学意义(P<0.05)。治疗期间观察组不良反应发生率(18.00%)与对照组(16.00%)比较,差异无统计学意义(P>0.05)。结论稳心颗粒对提升PAF患者窦性心律维持有效率及治疗有效率具有积极作用,能改善患者左房功能,抑制心肌纤维化,可能与调节胶原蛋白含量有关,且不增加用药风险。
Objective To investigate the effects of Wenxin Granules on sinus rhythm maintenance and myocardial fibrosis in patients with paroxysmal atrial fibrillation(PAF).Methods A total of 100 patients with PAF admitted to Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine in Shanghai from May 2019 to May 2021 were enrolled andrandomly divided into a control group and an observation group according to random envelopes,with 50 cases in each group.All patients were treated with amiodarone hydrochloride tablets,while those in the observation group received additional Wenxin Granules.After eight weeks of treatment,the efficacy and safety of the two groups were evaluated.The ventricular rate,duration of PAF attacks,left atrial functions[left ventricular ejection fraction(LVEF)and left atrial diameter(LAD)],and serum fibrosis indexes[typeⅢprocollagen amino terminal peptide(PⅢNP)andmatrix metalloproteinase-2(MMP-2)]of the two groups before and three months after treatment were compared.Meanwhile,the effective rates ofsinus rhythm maintenance were compared between the two groups three and six months after treatment.Results The total effective rate of the observation group was 90.00%(45/50),higher than 72.00%(36/50)in the control group(P<0.05).After three months of treatment,the ventricular rate and duration of PAF attacks in the two groups were lower than those before treatment(P<0.05).Compared with the control group,the ventricular rate and the duration of PAF attacks in the observation group decreased(P<0.05).After three and six months of treatment,the effective rate of sinus rhythm maintenance in the observation group was higher than that in the control group(P<0.05).After three months of treatment,the LVEF was higher and LAD was lower than those before treatment(P<0.05).Compared with the control group,LVEF in the observation group was elevated,and LAD was reduced(P<0.05).After three months of treatment,the serum MMP-2 and PⅢNP levels of the two groups were lower than those before treatment(P<0.05).Compared with the control group,the serum MMP-2 and PⅢNP levels in the observation group were reduced(P<0.05).During the treatment period,the incidence of adverse reactions in the observation group was 18.00%,which was not significantly different from 16.00%in the control group(P>0.05).Conclusion Wenxin Granules have a positive effect on the effective rate of sinus rhythm maintenance and treatment efficiency in PAF patients.They can improve the left atrial function of patients and inhibit myocardial fibrosis,which may be related to the regulation of collagen content without increasing the risk of medication.
作者
王传慧
张超
谭美春
潘扬
WANG Chuan-hui;ZHANG Chao;TAN Mei-chun;PAN Yang(Department of Internal Medicine,Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999;Department of Emergency/Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999)
出处
《世界中西医结合杂志》
2022年第7期1376-1379,1383,共5页
World Journal of Integrated Traditional and Western Medicine
基金
2020年上海市卫生健康委员会科研计划项目(202040398)
上海市宝山区科学技术委员会科技创新专项项目(19-E-42)。
关键词
稳心颗粒
阵发性房颤
窦性心律维持
心肌纤维化
Wenxin Granules
Paroxysmal Atrial Fibrillation
Sinus Rhythm Maintenance
Myocardial Fibrosis
