房颤合并慢性充血性心力衰竭患者的心室率控制对NT-proBNP及心功能的影响

Effect of ventricular rate control in patients with atrial fibrillation complicated with chronic congestive heart failure on NT-proBNP and cardiac function

目的探讨房颤合并慢性充血性心力衰竭心室率控制对NT-proBNP及心功能的影响。方法选取2016年3月至2017年3月我院120例房颤合并慢性充血性心力衰竭患者为研究对象,所有患者均采用美托洛尔联合胺碘酮控制目标心室率,并将其分为高心室率组(80～99次/min)及低心室率组(60～79次/min),每组60例。比较两组患者的心功能、NT-proBNP及临床症状变化。结果治疗后,两组患者各心功能指标较治疗前均明显改善,且高心室率组优于低心室率组(P<0.05)。治疗6、12个月后,两组患者的NT-proBNP水平均低于治疗前,且高心室率组低于低心室率组(P<0.05)。治疗后,高心室率组患者的临床症状减轻率显著高于低心室率组(P<0.05)。结论将房颤合并慢性充血性心力衰竭患者心室率控制在80～99次/min范围有助于改善患者的临床症状及心功能,对改善预后具有重要的临床意义。

Objective To explore the effect of ventricular rate control in patients with atrial fibrillation complicated with chronic congestive heart failure on NT-proBNP and cardiac function. Methods One hundred and twenty patients with atrial fibrillation and chronic congestive heart failure in our hospital were selected as study objects from March 2016 to March 2017.All patients were treated with metoprolol combined with amiodarone to control the target ventricular rate, and patients were divided into high ventricular rate group（80-99 times/min） and low ventricular rate group（60-79 times/min）, with 60 cases in each group. The cardiac function, NT-proBNP and clinical symptoms in the two groups were compared. Results After treatment,the cardiac function indexes of the two groups significantly improved compared with those before treatment, and those of the high ventricular rate group were superior to the low ventricular rate group（P〈0.05）. After 6 and 12 months of treatment, the levels of NT-proBNP in the two groups were lower than those before treatment, and those of the high ventricular rate group were lower than the low ventricular rate group（P〈0.05）. After treatment, the clinical symptom reduction rate of patients in the high ventricular rate was significantly higher than that of low ventricular rate group（P〈0.05）. Conclusion The ventricular rate of patients with atrial fibrillation and chronic congestive heart failure in the range of 80-99 times/min will help to improve the clinical symptoms and cardiac function, which has important clinical significance in improving the prognosis.