射频导管消融术对室上性心动过速患者长期生活质量的影响

Effect of radiofrequency catheter ablation on long-term quality of life in patients with supraventricular tachycardia

目的 探讨射频导管消融术对室上性心动过速（SVT）患者长期生活质量的影响。方法 选取2008年1月至2010年12月于新疆维吾尔自治区人民医院行十二导联心电图或24 h动态心电图确诊为SVT患者584例。将患者分为手术组（260例）与非手术组（324例），手术组患者行射频导管消融术治疗，非手术组给予药物治疗。随访患者5年，记录并比较2组患者治疗后2、5年疾病复发率、满意度、全因死亡率、心血管事件发生率和SF-36健康状况调查问卷评价情况。结果 治疗后2年，584例患者中失访68例，其中手术组33例，非手术组35例；成功随访516例，其中手术组227例，非手术组289例。治疗后5年（排除治疗后2年的结果），失访42例，其中手术组20例，非手术组22例；成功随访474例，其中手术组207例，非手术组267例。手术组治疗后2、5年疾病复发率低于非手术组［29.1%（66/227）比40.5%（117/289）、35.7%（74/207）比47.6%（127/267）］，差异有统计学意义（P＜0.05）。手术组治疗后2、5年满意度高于非手术组［67.4%（153/227）比59.5%（172/289）、76.3%（158/207）比50.9%（136/267）］，差异有统计学意义（P＜0.05）。手术组治疗后2、5年全因死亡率与心血管事件发生率均明显低于非手术组［全因死亡率：4.8%（11/227）比8.7%（25/289）、6.3%（13/207）比11.2%（30/267）；心血管事件：1.8%（4/227）比5.5%（16/289）、2.4%（5/207）比8.6%（23/267）］,差异均有统计学意义（均P＜0.05）；2组治疗后5年全因死亡率和心血管事件发生率分别与本组治疗后2年比较，差异均无统计学意义（均P＞0.05）。治疗前，2组患者SF-36总分比较，差异无统计学意义（P＞0.05）。治疗后2、5年，手术组SF-36总分均明显高于非手术组［（578±113）分比（539±106）分、（597±128）分比（503±119）分］，差异均有统计学意义（均P＜0.05）。结论 射频导管消融术治疗SVT患者在复发率、满意度、全因死亡率、心血管事件发生率及生活质量方面均优于药物治疗。

Objective To investigate the effect of radiofrequency catheter ablation on long-term quality of life in patients with supraventricular tachycardia（SVT）. Methods Totally 584 patients undergoing SVT were enrolled from January 2008 to December 2010 in People′s Hospital of Xinjiang Uygur Autonomous Region; 260 patients had radiofrequency catheter ablation（operation group） and 324 patients had drug therapy（non-operation group）. All patients were followed up for 5 years; recurrence rate, patient degree of satisfaction, all-cause mortality rate, cardiovascular event rate and score of SF-36 health scale were analyzed. Results Among 584 patients, 68 cases（33 cases in operation group and 35 cases in non-operation group） were lost of follow-up in 2 years, 227 cases in operation group and 289 cases in non-operation group were successfully followed; 42 patients（20 cases in operation group and 22 cases in non-operation group） were lost of follow-up during 3-5 years; 207 cases in operation group and 267 cases in non-operation group had complete 5-year follow-up data. The 2, 5-year recurrence rates in operation group were significantly lower than those in non-operation group［29.1%（66/227） vs 40.5%（117/289）, 35.7%（74/207） vs 47.6%（127/267）］（P＜0.05）. The 2, 5-year satisfaction rates in operation group were significantly higher than those in non-operation group［67.4%（153/227） vs 59.5%（172/289）, 76.3%（158/207） vs 50.9%（136/267）］（P＜0.05）. The 2, 5-year all-cause mortality rates and cardiovascular event rates in operation group were significantly lower than those in non-operation group［all-cause mortality： 4.8%（11/227） vs 8.7%（25/289）, 6.3%（13/207） vs 11.2%（30/267）； cardiovascular events： 1.8%（4/227） vs 5.5%（16/289）, 2.4%（5/207） vs 8.6%（23/267）］（P＜0.05）. There were no significant differences between the 2-year and 5-year all-cause mortality rate and cardiovascular event rate in both groups（P＞0.05）. The 2, 5-year SF-36 scores in operation group were significantly higher than those in non-operation group［（578±113）scores vs （539±106）scores, （597±128）scores vs （503±119）scores］（P＜0.05）. Conclusion Radiofrequency catheter ablation is superior to drug therapy in relapse rate, patient satisfaction, all-cause mortality, cardiovascular events and quality of life in patients with SVT.