阿托伐他汀与瑞舒伐他汀对阵发性心房颤动患者射频消融术后复发率及心房电重构的影响比较

Comparison of the effects of atorvastatin and rosuvastatin on recurrence rate and atrial electrical remodeling after radiofrequency ablation in patients with paroxysmal atrial fibrillation

目的比较阿托伐他汀与瑞舒伐他汀对阵发性心房颤动患者射频消融术后复发率及心房电重构的影响。方法选择2019年1月至2020年6月于郑州大学附属洛阳中心医院心内科接受射频消融的阵发性房颤患者120例,采用随机数字表法分为阿托伐他汀组、瑞舒伐他汀组以及无他汀治疗组,每组40例。三组术后均接受口服奥美拉唑治疗1个月,华法林或利伐沙班治疗至少2个月,胺碘酮治疗3个月。在此基础上,阿托伐他汀组术后接受阿托伐他汀治疗,20 mg/次,1次/d;瑞舒伐他汀组接受瑞舒伐他汀治疗,10 mg/次,1次/d,疗程均为3个月。无他汀治疗组不加用任何他汀类药物。比较三组术后6个月房颤复发率、心电图P波离散度及低密度脂蛋白水平。结果在术后6个月内,阿托伐他汀组房颤复发8例(20.00%),瑞舒伐他汀组10例(25.00%),无他汀治疗组12例(30.00%),三组房颤复发率比较差异无统计学意义(χ^(2)=1.067,P=0.587)。在术后6个月,阿托伐他汀组P波离散度较术前显著降低(P<0.05),但瑞舒伐他汀组、无他汀治疗组术后6个月的P波离散度与术前比较差异无统计学意义(P>0.05)。阿托伐他汀组和瑞舒伐他汀组的低密度脂蛋白水平均较术前显著降低(P<0.05),但无他汀治疗组术后6个月的低密度脂蛋白水平与术前比较差异无统计学意义(P>0.05)。结论阿托伐他汀与瑞舒伐他汀对于阵发性心房颤动患者射频消融术后的短期复发率无显著差异,但阿托伐他汀组P波离散度降低更为明显,提示亲脂性的阿托伐他汀更有利于改善心房电学重构。

Objective To compare the effects of atorvastatin and rosuvastatin on recurrence rate and atrial electrical remodeling after radiofrequency ablation in patients with paroxysmal atrial fibrillation.Methods One hundred and twenty patients with paroxysmal atrial fibrillation who underwent radiofrequency ablation in Department of Cardiology,Luoyang Central Hospital Affiliated to Zhengzhou University from January 2019 to June 2020 were selected and divided into the atorvastatin group,the rosuvastatin group and the non-statin treatment group by random number table method,with 40 cases in each group.All the three groups received oral omeprazole treatment for 1 month,warfarin or rivaroxaban treatment for at least 2 months,and amiodarone treatment for 3 months.On this basis,the atorvastatin group received atorvastatin treatment,20 mg each time,once a day,for 3 months,and the rosuvastatin group received rosuvastatin treatment,10 mg each time,once a day,for 3 months.The non-statin treatment group did not receive any statin.The recurrence rate of atrial fibrillation,P-wave dispersion of electrocardiogram and low-density lipoprotein level were compared among the three groups 6 months after operation.Results Within 6 months after operation,atrial fibrillation recurred in 8 cases(20.00%)in the atorvastatin group,10 cases(25.00%)in the rosuvastatin group,and 12 cases(30.00%)in the non-statin treatment group.There was no significant difference in the recurrence rate of atrial fibrillation among the three groups(χ^(2)=1.067,P=0.587).Compared with that before operation,the P-wave dispersion of electrocardiogram in the atorvastatin group reduced significantly 6 months after operation(P<0.05).However,compared with that before operation,the P-wave dispersion of electrocardiogram in the rosuvastatin group and the non-statin treatment group was not significantly different 6 months after the operation(P>0.05).Compared with those before operation,the levels of low-density lipoprotein in the atorvastatin group and the resuvastatin group reduced significantly 6 months after operation(P<0.05).However,compared with that before operation,the level of low-desity lipoprotein in the non-statin treatment group was not significantly different 6 months after the operation(P<0.05).Conclusion There is no significant difference between atorvastatin and rosuvastatin in the short-term recurrence rate of patients with paroxysmal atrial fibrillation after radiofrequency ablation,but the P-wave dispersion of electrocardiogram of the atorvastatin group decreases more significantly,suggesting that lipophilic atorvastatin is more conducive to improving atrial electrical remodeling.