慢性充血性心力衰竭伴持续性房颤患者心室率控制的疗效观察

Effect Observation of Controlling Ventricular Rate in Treatment of Chronic Congestive Heart Failure with Persistence Atrial Fibrillation

目的：观察慢性充血性心力衰竭（CCHF）伴持续性快速房颤（AF）患者治疗中不同心室率控制水平的临床疗效及心功能变化。方法：将CCHF伴持续性快速AF患者90例,随机分为对照组45例与治疗组45例。两组常规治疗,治疗组患者心室率控制在静息55-70 min^-1,活动后≤90 min^-1;对照组患者心室率控制在静息71-85 min^-1,活动后≤110 min^-1,治疗6个月。观察治疗前和治疗后6个月时的临床症状、指标变化。结果：两组治疗后临床症状、左心室舒张末期直径（LVEDD）、左心室射血分数（LVEF）、6分钟步行距离（6-MWT）较治疗前改善（P〈0.05）,且治疗组优于对照组（P〈0.05）结论：CCHF伴持续性快速AF患者治疗中心室率控制在较低水平能更显著改善临床症状及心功能。

Objective： To observe the effect of controlling ventrieular rate of chronic congestive heart failure （CCHF） with persistent atrial fibrillation （AF）. Methods： To select 90 patients with CCHF and persistence AF. They were randomly divided into two groups, treatment group （45 patients） and control group （45 patients）. Two groups were given routine remedy. Treat ment group＇s ventrieular rate at rest was controlled between 55 to 70 times a minute, after exercise was controlled under 90 times a minute. Control group＇s ventrieular rate at rest was controlled between 71 to 85 times a minute, after exercise was controlled under 110 times a minute. After 6 months, to compare the changes of clinical manifestations. Results： Two group＇s clinical symptom and some index of cardiac function including left ventrieular end -diastolic dimension （LVEDD）, left ventricular ejection fraction（LVEF） and 6 minutes walk distance（6 -MWT） were better than that of before treament （ P 〈 0. 05 ）, and treatment group was better than contr group （ P 〈 0. 05 ）. Conclusion： More low level of ventricular rate in the treatment of chronic congestive heart failure with persistently atrial fibrillation will improve clinical symptom and cardiac function.