稳心颗粒对缺血性心肌病房性心律失常及P波离散度的影响

Effects of Wenxin Granule on the atrial arrhythmias and P wave dispersion of ischemic cardiomyopathy

目的观察稳心颗粒对缺血性心肌病（ICM）患者房性心律失常及P波离散度（Pdisp）的影响。方法选取福建中医药大学附属第二人民医院心内科2012年1月～2013年12月住院的ICM患者84例,分为对照组（常规治疗）40例和治疗组（在常规治疗的基础上给予稳心颗粒每次1袋,每日3次,服药4周）44例。冠状动脉造影并计算SYNTAX评分,心电图和动态心电图检测房性心律失常并计算Pdisp,超声心动图检测心功能：左心室射血分数（LVEF）和短轴缩短率（FS）,快速化学发光法测定血清氨基末端B型钠尿肽原（NT-proBNP）。结果两组SYNTAX评分比较差异无统计学意义[（26.3±7.7）分比（25.5±8.1）分,P〉0.05];治疗组对房性心律失常的有效率显著高于对照组（79.5%比65.0%,P〈0.05）,血清NT-proBNP水平和Pdisp显著下降[（675.5±288.6）ng/L比（876.3±345.8）ng/L,（23±10）ms比（38±15）ms,均P〈0.05],LVEF和FS显著高于对照组[（52.5±12.2）%比（44.3±6.6）%,（37.4±11.3）%比（25.4±5.7）%,均P〈0.05]。结论稳心颗粒能显著缓解ICM患者房性心律失常,改善心功能、降低Pdisp可能是其作用机制。

Objective To investigate the effects of Wenxin Granule on the atrial arrhythmias and P wave dispersion（Pdisp） of ischemic cardiomyopathy（ICM）. Methods From January 2012 to December 2013, 84 inpatients of Department of Cardiology in the Second People＇s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were assigned to the control group（n = 40）, which were treated routinely and the Wenxin Granule group（n = 44）,which were given Wenxin Granule once a package, 3 times a day, for 4 weeks, besides routine treatment. Coronary angiography was performed and SYNTAX score was calculated. ECG and Holter were examined and Pdisp was measured.Left ventricular ejection fraction（LVEF） and fractional shortening（FS） was tested by echocardiography. Serum level of N-terminal pro B-type natriuretic peptide（NT-proBNP） was detected by rapid chemilumininescence. Results No differences in SYNTAX score between the two groups [（26.3±7.7） points vs（25.5±8.1） points, P 〉0.05]. Compared with the control group, atrial arrhythmias（79.5% vs 65.0%, P 〈0.05） and Pdisp [（23±10） ms vs（38±15） ms, P〈 0.05] were significantly decreased, LVEF and FS increased [（52.5±12.2）% vs（44.3±6.6）%,（37.4±11.3）% vs（25.4±5.7）%,all P 〈0.05], and serum levels of NT-proBNP [（675.5±288.6） ng/L vs（876.3±345.8） ng/L, P 〈0.05] reduced in Wenxin Granule group. Conclusion Wenxin Granule can greatly ameliorative atrial arrhythmias of ICM, which may be the results of its improvement of cardiac function and decrease of Pdisp.