盐酸索他洛尔对阵发性房颤患者心房易颤期的影响及疗效观察

Effect of sotalol hydrochloride on atrial vulnerable period in patients with paroxysmal atrial fibrillation

目的评价盐酸索他洛尔对阵发性房颤患者心房易颤期的影响及疗效观察。方法通过严格筛选同期50例阵发性房颤的患者作为阵发性房颤组,50例无房颤发作史的心慌待查患者作为非房颤组,使用经食管心房调搏仪对两组患者心房易颤期进行测量,并对房颤患者的易颤期与既往1年的发作次数进行回归分析;50例房颤患者恢复窦律后,随机将其分为干预组及安慰剂组,分别给予盐酸索他洛尔(40 mg,2次/d)及安慰剂治疗,临床观察时间为6个月,若有房颤发作则观察终止,结束后进行生存分析,并对其再次进行心房易颤期的测量,同时对干预组进行治疗前后的配对检验。结果阵发性房颤组50例中有39例房颤诱发,而非房颤组仅有7例患者有房颤诱发,阵发性房颤组易颤期明显长于非房颤组(P<0.01);50例房颤患者易颤期与既往1年发作次数正相关(P<0.01);盐酸索他洛尔干预组房颤复发率为28%,安慰剂组复发率为64%,干预组复发率明显低于安慰剂组(P<0.05);盐酸索他洛尔治疗后再次对易颤期进行测量,干预组易颤期明显缩短(P<0.05),且与干预前进行配对检测亦明显缩短(P<0.01)。结论阵发性房颤患者心房易颤期明显延长,且与发作频率正相关,应用盐酸索他洛尔进行治疗,可以明显缩短阵发性房颤患者的心房易颤期,并降低复发率,从而改善了患者的生活质量,并减少就诊及住院次数。

AIM To evaluate the effect of sotalol hydrochloride on atrial vulnerable period in patients with paroxysmal atrial fibrillation.METHOD 50 patients with paroxysmal atrial fibrillation were selected as PAF group and 50 patients without atrial fibrillation as non-PAF group.Atrial vulnerable period was measured through esophagus atrial pacing in both groups.Regression analysis was performed between atrial vulnerable period and the frequency of episodes in one year.After recovering sinus rhythm,50 patients with atrial fibrillation were randomly divided into intervention group and placebo group.They were treated with sotalol hydrochloride(40 mg,twice a day)and placebo respectively.The clinical observation lasted for six months.If atrial fibrillation recurred,the observation was terminated.Survival analysis was performed after the end of the observation,and the atrial vulnerable period was measured again,and the paired test was performed after the intervention.RESULTS 39 cases were induced by atrial fibrillation in PAF group,while only 7 cases in non-PAF group were induced.The atrial vulnerable period of PAF group was significantly longer than that of non-PAF group(t=4.541,P<0.01).The atrial vulnerable period in 50 cases of atrial fibrillation was positively correlated with the frequency of episodes in the previous year(P<0.01).The recurrence rate of atrial fibrillation was 28%in the sotalol hydrochloride intervention group and 64%in the placebo group.The recurrence rate of the intervention group was significantly lower than that of the placebo group(P<0.05),and the atrial vulnerable period of the intervention group was significantly shortened(P<0.05),and was also significantly shorter than before intervention(P<0.01).CONCLUSION The atrial vulnerable period of patients with paroxysmal atrial fibrillation is significantly prolonged and positively correlated with the frequency of episodes.Sotalol hydrochloride can significantly shorten the atrial vulnerable period and reduce the recurrence rate,thus improving the quality of life,reducing the number of visits and hospitalizations.