不同剂量的瑞舒伐他汀对心房颤动患者心房纤维化程度的影响

Influence of rosuvastatin in different doses on severity of atrial fibrosis in patients with atrial fibrillation

目的探讨不同剂量的瑞舒伐他汀对行导管射频消融术的心房颤动(房颤)患者心房纤维化程度的影响。方法连续纳入150例CARTO指导的首次行导管射频消融术的房颤患者,术中在窦性心律下对左心房进行高密度电压标测,左心房低电压面积比反映心房纤维化程度,术后采用随机数字表法将患者分为3组,分别给予常规处理和不同剂量的瑞舒伐他汀:对照组,小剂量组(10 mg/d)和中剂量组(20 mg/d),随访期为3月;采用酶联免疫吸附法(ELISA)测定血清趋化素(chemerin)和半乳糖凝集素-3(Gal-3)水平;chemerin和Gal-3水平与心房纤维化程度的相关性用Pearson相关分析。结果治疗前,3组患者的左心房低电压面积比、chemerin和Gal-3水平比较差异无统计学意义(P>0.05);相关性分析显示,血清chemerin(r=0.732,P<0.01)和Gal-3(r=0.837,P<0.01)水平与心房纤维化程度呈正相关;术后3月,3组患者的chemerin和Gal-3水平较术前均降低,差异有统计学意义(P<0.05);与对照组相比,不同剂量瑞舒伐他汀均能降低chemerin和Gal-3水平,而中剂量组降低的更明显[(101.2±20.7)ng/ml vs.(135.3±19.2)ng/ml,(2.2±1.1)ng/ml vs.(4.8±1.3)ng/ml],差异有统计学意义(P<0.05)。结论瑞舒伐他汀可降低血清chemerin和Gal-3水平,推测其可以减轻心房纤维化程度,且呈剂量依赖性。

Objective To discuss the influence of rosuvastatin in different doses on severity of atrial fibrosis in patients with atrial fibrillation(AF)undergone radiofrequency catheter ablation(RFCA).Methods AF patients(n=150)undergone the first RFCA guided by CARTO were chosen continuously.During RFCA,the left atrium was given high density voltage mapping in sinus rhythm,and severity of atrial fibrosis was reflected by the area ratio of left atrial low voltage.The patients were divided into 3 groups by using random digital table after RFCA,and given respectively routine treatment and rosuvastatin in different doses:control group,low-dose rosuvastatin group(10 mg/d)and mid-dose rosuvastatin group(20 mg/d).All groups were followed up for 3 months.The levels of serum chemerin(CHEM)and galectin-3(Gal-3)were detected by using ELISA.The correlation among CHEM,Gal-3 and severity of atrial fibrosis was analyzed by using Pearson correlation analysis.Results Before treatment,the difference in area ratio of left atrial low voltage,CHEM level and Gal-3 level had no stistical significance among 3 groups(P>0.05).The results of correlation analysis showed that levels of serum CHEM(r=0.732,P<0.01)and Gal-3(r=0.837,P<0.01)were positively correlated to severity of atrial fibrosis.After RFCA for 3 months,levels of serum CHEM and Gal-3 decreased in 3 groups than those before(P<0.05).Compared with control group,the levels of CHEM and Gal-3 were decreased in rosuvastatin groups,and decreases of CHEM[(101.2±20.7)ng/ml vs.(135.3±19.2)ng/ml]and Gal-3[(2.2±1.1)ng/ml vs.(4.8±1.3)ng/ml]were more significant in mid-dose rosuvastatin group than those in control group(P<0.05).Conclusion Rosuvastatin can reduce the levels of serum CHEM and Gal-3,which suggests that it can relieve the severity of atrial fibrosis in a dose-dependent manner.