普罗帕酮与胺碘酮治疗心律失常效果对比及其对血清hs-CRP的影响

Clinical effect of propafenone versus amiodarone in treatment of arrhythmia and their effect on serum level of high-sensitivity C-reactive protein

目的探讨观察在心律失常患者中分别应用普罗帕酮与胺碘酮的疗效及不同治疗方案对血清超敏C反应蛋白(hs-CRP)水平的影响。方法选取92例心律失常患者随机、均等分为甲组和乙组;两组分别给予普罗帕酮与胺碘酮治疗,将临床疗效、血清hs-CRP及心率变异相关参数变化及不良反应作为观察指标,评估不同治疗方案的应用价值。结果甲组与乙组康复、有效和无效等级差异显著显著(P<0.05),且甲组总有效率(78.26%)远低于乙组(97.83%)(P<0.05);治疗后血清hs-CRP均较治疗前显著降低(P<0.05),且治疗后乙组远低于甲组(P<0.05);治疗后rMSSD、SDNN和sDNNindex均较治疗前显著升高(P<0.05),且治疗后乙组各指标水平均远高于甲组(P<0.05);甲组不良反应发生率远高于乙组(P<0.05)。结论胺碘酮在心律失常治疗中的效果和安全性均较普罗帕酮有明显的优势,且对hs-CRP的抑制作用也更为理想。

Objective To investigate the clinical effect of propafenone versus amiodarone in the treatment of arrhythmia and the effect of different therapeutic regimens on serum level of high-sensitivity C-reactive protein （hs- CRP）. Methods A total of 92 patients with arrhythmia were randomly and equally divided into group A and group B. The patients in group A were given propafenone and those in group B were given amiodarone. The clinical outcome, serum hs-CRP level, heart rate variability indices, and adverse events were observed in the two groups to evaluate the value of difference therapeutic regimens. Results There were significant differences between groups A and B in the proportion of patients who achieved rehabilitation, had response, or had no response （P 〈0.05）. Group A had a significantly lower overall response rate than group B （78.26% vs 97.83%, P〈O.05）. Both groups had a significant reduction in serum hs-CRP level after treatment （P〈O.05）, and group B had a significantly lower serum hs-CRP level than group A after treatment （P〈0.05）. Both groups had significant increases in root mean squared successive difference, standard deviation of all normal sinus RR intervals （SDNN）, and SDNN index after treatment （P〈O.05）, and group B had significantly higher indices than group A after treatment （P〈O.05）. Group A had a significantly higher incidence rate of adverse events than group B （P〈0.05）. Conclusion Amiodarone has significantly better clinical effect and safety than propafenone in the treatment of arrhythmia. It also has a more ideal inhibitory effect on hs-CRP.