LS7综合干预对预防心房颤动患者射频消融术后复发的价值

Predictive value of Life’s Simple 7 score for recurrence of atrial fibrillation after radiofrequency ablation

目的探讨简单7步骤生活指南(LS7)综合干预对预防心房颤动患者射频消融术后复发的价值。方法选择阵发性心房颤动并行射频消融术的71例患者,分为LS7组36例和对照组35例。对2组患者进行LS7评价,对照组术后予抗心律失常、抗凝及其相关疾病治疗,LS7组在对照组基础上针对LS7"一般"和"差"2个层次进行综合干预,比较2组在治疗前和治疗12月后(治疗后)的心脏彩色多普勒超声指标、收缩压、舒张压、CRP、N末端B型利钠肽原(NT-proBNP)、血糖、血脂,并计算2组CHA2DS2-VASc积分和LS7总分,比较2组射频消融术后心房颤动的复发率。结果治疗后LS7组患者的NT-proBNP、CRP水平均低于治疗前(P均<0.05),其NT-proBNP、CRP、舒张压、空腹血糖、总胆固醇、LDL-C、BMI均低于对照组(P均<0.05)。治疗后2组心房颤动患者的LS7总分均较治疗前升高(P均<0.05),LS7组患者治疗后的LS7总分高于对照组,其术后复发率亦低于对照组(P均<0.05)。结论LS7综合干预可有效提升射频消融术后患者心血管健康状况,预防心房颤动术后复发。

Objective To investigate the predictive value of Life’s Simple 7 score for the recurrence of atrial fibrillation after radiofrequency ablation.Methods Seventy-one patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation were recruited and randomly divided into the control(n=35)and LS7 intervention groups(n=36).LS7 score assessment was performed between two groups.Patients in the control group were treated with anti-arrhythmia,anti-coagulation and related diseases after operation,and those in the LS7 group were given with comprehensive intervention according to average and poor LS7 scores based on the treatment in the control group.Before and 12 months after corresponding interventions,cardiovascular health score(LS7 score),cardiac color Doppler ultrasound parameters,systolic and diastolic blood pressure,C-reactive protein(CRP),NT-proBNP,blood glucose,blood lipid were measured and compared between two groups.The CHA2DS2-VASc and LS7 scores were calculated in two groups.The recurrence rate of atrial fibrillation after radiofrequency ablation was statistically compared between two groups.Results The CRP and NT-ProBNP levels in the LS7 group were significantly declined after treatment(both P<0.05).In the LS7 group,CRP and NT-ProBNP levels,diastolic blood pressure,fasting blood glucose,total cholesterol,low-density lipoprotein(LDL-C)and body mass index(BMI)were significantly lower than those in the control group(all P<0.05).In the LS7 group,the total LS7 score was remarkably higher,whereas the postoperative recurrence rate of atrial fibrillation was significantly lower compared with those in the control group after treatment(both P<0.05).Conclusion LS7 comprehensive intervention can effectively improve the cardiovascular status after radiofrequency ablation and prevent the postoperative recurrence of atrial fibrillation in atrial fibrillation patients.