起搏方式及瑞舒伐他汀钙对起搏术后心房颤动发生率及C反应蛋白的影响

Influence of pacing modes and rosuvastatin calcium on incidence of atrial fibrillation and CRP concentration after permant pacemake therapy

目的:探讨心脏起搏方式及瑞舒伐他汀钙对起搏术后血浆C反应蛋白(CRP)浓度及心房颤动(房颤)发生率的影响。方法:将植入起搏器资料完整且排除房颤的缓慢性心律失常患者239例,按植入起搏器类型分为DDD组(92例)与VVI组(147例),各组再按是否加用瑞舒伐他汀治疗分为两个亚组:治疗组(常规治疗+瑞舒伐他汀)与对照组(常规治疗)。测定术前及术后1、6、12、24个月时的血浆CRP浓度,随访观察24个月,记录房颤发生率。结果:DDD组与VVI组术后24个月房颤发生率以及术后6、12、24个月的CRP浓度均差异有统计学意义(均P<0.05);术后24个月DDD组两亚组CRP浓度差异有统计学意义(P<0.05),房颤发生率差异无统计学意义;VVI组两亚组术前CRP浓度差异无统计学意义,术后1、3、6、12个月的CRP浓度及24个月后房颤发生率差异有统计学意义(均P<0.05)。结论:DDD起搏方式与瑞舒伐他汀可能更能降低房颤发生率及血浆CRP。

Objective：To investigate the influence of pacing modes and rosuvastatin calcium on incidence of atri al fibrillation and CRP concentration after permant paeemake therapy. Method：According to the type of pacemaker implantation, 239 cases with implanted pacemaker and eliminating slow arrhythmia were divided into DDD group （n = 92） and VVI group （n = 147）, then each group was divided into treatment subgroup （conventional with rosu vastatin therapy） and control subgroup （conventional therapy）. Plasma CRP concentration was measured at 0, 1, 6, 12, 24 months after operation. All cases were followed up for 24 months to record the incidence of atrial fibril lation. Result：The postoperative incidence of atrial fibrillation at 24 months the CRP concentration at 6, 12 and 24 months were significantly different between DDD group and VVI group （all P〈0.05）. At 24 months, the differ ence of CRP concentration was statistically significant in DDD subgroups （P〈0.05）, while no significant differ enee in incidence of atrial fibrillation. In VVI subgroups, the difference of CRP concentration was not statistically significant before operation while opposite at 1, 3, 6, 12 months after operation, and the incidence of atrial fibrillation at 24 months was statistically significant. Conclusion：DDD pacing mode and rosuvastatin may reduce postop erative CRP level and incidence of atrial fibrillation.