阵发性心房颤动导管消融与药物治疗对患者远期生活质量影响的对比研究

Influence of catheter ablation and drug therapy on long-term quality of life in patients with paroxysmal atrial fibrillation:a comparative study

目的对比阵发性心房颤动(房颤)患者导管消融与药物治疗后远期生活质量的变化。方法选取2018年1月至2018年6月于河南省人民医院心血管内科收治的30例接受导管消融和30例选择抗心律失常药物治疗的阵发性房颤患者为研究对象。比较导管消融和药物治疗基线和18个月内SF-36健康调查量表中PCS值和MCS值、焦虑自评量表(SAS)值和抑郁自评量表(SDS)值的变化。结果导管消融组与药物治疗组的基线临床资料,基线生活质量及精神状态资料均无显著性差异(P>0.05)。导管消融组术后18个月内PCS值和MCS值增幅均显著大于药物治疗组(P<0.01)。导管消融组SDS值和SAS值降幅均显著大于药物治疗组(P<0.05)。多因素回归分析结果表明,导管消融、未复发房颤及未服用抗凝药是阵发性房颤患者生活质量提高、焦虑和抑郁状态改善的主要预测因素。结论导管消融较抗心律失常药物治疗能够更好地改善阵发性房颤患者生活质量,减轻抑郁和焦虑。

Objective To compare the changes of long-term quality of life(QOL)in patients with paroxysmal atrial fibrillation(PAF)after treatment of catheter ablation(CA)and drug therapy.Methods PAF patients(n=30)received CA treatment(CA group)and patients(n=30)received anti-AF drug therapy(drug group)were chosen from Department of Cardiovascular Medicine in People’s Hospital of Henan Province from Jan.2018 to June 2018.The baseline data and changes of value of physical component summary(PCS)and mental component summary(MCS)in the MOS 36-item Short Form Health Survey(SF-36),and value of self-rating anxiety scale(SAS)and self-rating depressive scale(SDS)between 2 groups within 18 months after the treatment.Results The difference in baseline clinical data,and baseline QOL and mental state data had no statistical significance between 2 groups(P>0.05).The increasing ranges of PCS value and MCS value were significantly higher in CA group than those in drug group(P<0.01)within 18 months after treatment.The increasing ranges of SDS value and SAS value were significantly higher in CA group than those in drug group(P<0.01).The results of multi-factor regression analysis showed that CA,non-recurrence of AF and not taking anticoagulants were major predictive factors of promoting QOL and relieving anxiety and depression in PAF patients.Conclusion Compared with anti-AF drug,CA can more effectively improve QOL and relieve anxiety and depression in PAF patients.