氟伐他汀对血脂正常的急性冠脉综合征患者房颤复发的防治作用

Prophylactic and therapeutic effect of fluvastatin on the recurrence of atrial fibrillation in patients with acute coronary syndroms but without dyslipidemia

目的探讨氟伐他汀对血脂正常的急性冠状动脉综合征患者房颤复发的防治作用。方法98例首次并发阵发性房颤且在1周内转复的血脂正常的急性冠状动脉综合征患者被随机分为治疗组(除常规治疗外,加服氟伐他汀20 mg/d,62例)和对照组(仅常规治疗,36例)。治疗后随访12个月,记录房颤复发及其持续时间,并于治疗前和治疗12个月时分别进行1次血脂测定。使用SPSS13.0统计软件包对2组数据进行统计分析。结果治疗组阵发性房颤复发8例(12.9%),对照组复发15例(41.7%),2组比较具有显著性差异(x^2=10.5,P<0.01);治疗组阵发性房颤转为持续性或永久性房颤3例(4.8%),对照组为9例(25.0%),差异具有显著性(x^2=8.62,P<0.01)。治疗组的血脂在治疗12个月时较治疗前明显改善,总胆固醇、低密度脂蛋白胆固醇和甘油三酯显著下降,高密度脂蛋白胆固醇升高(P<0.05),而对照组的血脂则在治疗前后无明显改变。结论氟伐他汀对血脂正常的急性冠状动脉综合征患者房颤的复发具有明显的防治作用,可显著降低持续性或永久性房颤的发生率。

Objective To explore the prophylactic and therapeutic effect of fluvastatin on the recurrence of atrial fibrillation in patients with acute coronary syndroms but with average lipid levels. Methods A cohort of 98 consecutive patients with acute coronary syndroms combined with paroxysmal atrial fibrillation but subsequently successful cardloversion within one week and with normal lipidemia were randomly as- signed to fluvastatin group and control group. The former group including 62 recruited patients was administered fluvastatin in addition to routine medication, while the latter group compfizing 36 registered cases was merely offered routine remedy. All the subjects were followed up for 12 months in order to observe and record the profiles of recurrent atrial fibrillations. The serum lipid levels in every individuals were determined respectively before and after a medical course of 12-month theraputical management. A suite of SPSS software （version 13.0） was applied to performing statistical analysis. Results The rate of recurrence of atrial fibrillations in fluvastatin group was significantly less than that in control group during 12 months of follow-up （ 12.9% vs 41.7%, ）（2 = 10.5, P 〈 0.01 ）. Additionally, fluvastatin was associated with a statistically reduced risk for the transversion of paroxysmal atrial fibrillations into persistant or permanent status （4.8% vs 25.0% ,Aft = 8. 62, P 〈 0. 01 ）. Furthermore, the profile of serum lipid in the fluvastatin group was ameliorated at the termination of a 12-month course of treatment （P 〈 0. 05 ） compared with that before therapy, whereas it was not the case in the control group. Conclusions Fluvastatin significantly exerts the prophylac- tic and therapeutic effect on the recurrence of atrial fibrillation in patients with acute coronary syndroms but with no dyslipidemia by decreasing the frequences for paroxysmal atrial fibrillations to recur or transit into persistant or permanent ones.