瑞舒伐他汀的剂量大小对房颤射频消融术后复发的影响

THE EFFECT OF DIFFERENT DOSES OF ROSUVASTATIN ON THE RECURRENCE OF ATRIAL FIBRILLATION AFTER RADIOFREQUENCY ABLATION

目的本研究基于房颤与血脂的关系、他汀调脂与抗炎的多效性,评估10mg瑞舒伐他汀对房颤射频消融术后复发的影响。方法收集临沂市人民医院心血管内科收治的阵发性房颤患者50例,随机分为瑞舒伐他汀治疗组(26例)和对照组(24例)。治疗组在服用治疗基础病原有药物的基础上术后即给瑞舒伐他汀10mg,每晚1次口服;对照组只服用治疗基础病的原有药物。术后随访12个月。观察两组患者术后12个月内的C反应蛋白、24h动态心电图、房颤复发情况、药物不良反应及安全性。选取同时期住院的符合纳入标准的50例非房颤患者作为对照,对比分析房颤组同非房颤组血脂(甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、脂蛋白a(Lp(a))水平的变化。结果 1血脂(TG、LDL、HDL、Lp(a))各参数,房颤组与非房颤组比较均降低,差异有统计学意义(P<0.05);2治疗组和对照组术前基础CRP水平差异无统计学意义(P>0.05);治疗组术后12个月CRP减少程度较对照组明显(P<0.05);治疗组和对照组在房颤复发率方面比较差异无显著性(P>0.05)。结论 1房颤患者血脂(TG、LDL、HDL、Lp(a))水平明显低于非房颤患者;2他汀类药物具有调脂外的多效性,即抗炎作用,10mg瑞舒伐他汀能协调其调脂及抗炎功效,对房颤射频消融术后炎症改变的恢复有明显作用;3房颤射频消融术后服用10mg瑞舒伐他汀有减少术后复发率的趋势。

Objective To evaluate the effect of different doses of rosuvastatin on the recurrence of atrial brillation（AF） after radiofrequency ablation based on the relationship between AF and lipids ,pleiotropy of statins in terms of lipid regulation and anti‐inflammatory effect .Methods 50 cases of paroxysmal AF admit‐ted to the Cardiovascular Internal Medicine Department ,Linyi City People＆#39;s Hospital ,were randomly di‐vided into the treatment group of 26 cases and the contrast group of 24 cases .The treatment group re‐ceived oral administration of rosuvastatin 10mg each night in addition to the routine therapy , and the contrast group received the routine therapy .In the 12‐month follow‐up surveys ,the content of C‐reactive pro‐tein （CRP） in 12 months ,the 24‐hour dynamic electro‐cardiogram ,the recurrence of AF ,the adverse drug re‐actions and safety were observed .50 non‐AF cases in the same period were chosen as controls .The con‐tents of triglycerides （TG） ,low density lipoprotein （LDL） ,high density lipoprotein （HDL） and lipopro‐tein a （Lp （a）） between AF patients and non‐AF cases were compared .Results The contents of TG ,LDL , HDL and Lp （a） in both groups decreased significantly （ P〈0 .05） .No significant changes occurred in the content of CRP in both groups （ P〉0 .05） .Greater changes occurred in the content of CRP 12 months af‐ter operation in the treatment group than in the contrast group （ P〈0 .05） .No significant changes in the recurrence of AF were found between the two groups （ P 〉0 .05） .Conclusion The contents of TG ,LDL , HDL and Lp （a） are obviously lower in AF patients than in non‐AF cases .Statins shows pleiotropy be‐sides lipid regulation ,10mg of rosuvastatin can coordinate lipid‐regulating and anti‐inflammatory effect and plays a significant role in the recovery of AF after radiofrequency ablation .Taking 10mg of rosuvastatin can reduce the recurrence rate after radiofrequency ablation of AF .