稳心颗粒用于合并心房心肌病心房颤动患者疗效分析

Efficacy analysis of Wenxin Keli for atrial fibrillation patients with atrial cardiomyopathy

目的观察稳心颗粒用于合并心房心肌病的心房颤动患者的临床疗效及安全性。方法将2020年1月-2021年6月江西省人民医院68例心房颤动合并心房心肌病的18~80岁患者,根据意愿分为实验组(稳心颗粒+胺碘酮)33例及对照组(胺碘酮)35例,稳心颗粒(每次9 g,每天3次)服用6个月,胺碘酮(每次200 mg,第1周每天3次,第2周每天2次,第3周每天1次,之后维持每天1次)服用3个月,观察两组患者6个月心电图QTc时限、超声心动图左心房大小、动态心电图房早负荷、用药不良反应、心房颤动复发、心力衰竭、卒中、死亡发生率。结果与对照组比较,实验组治疗后超声心动图示左心房内径缩小[(37.12±3.93)mm比(39.46±3.09)mm,P=0.008],动态心电图房早负荷减小[(1.28±1.68)%比(3.54±6.08)%,P=0.041],两组间差异具有显著性,且相比治疗前,实验组治疗后超声心动图示左心房内径缩小[(39.91±3.20)mm比(37.12±3.93)mm,P=0.002],治疗前后差异具有显著性。两组治疗后心房颤动复发差异具有显著性(P=0.030),其他事件发生率差异无显著性。结论稳心颗粒用于合并有心房心肌病的心房颤动患者安全、有效,可一定程度上减少心房颤动复发,改善心房重构,提高治疗效果。

Objective To observe the clinical efficacy and safety of Wenxin Keli for the patients after ablation of atrial fibrillation(AF)with atrial cardiomyopathy.Methods A total of 68 patients aged 18-80 years with atrial fibrillation complicated with atrial cardiomyopathy were enrolled in Jiangxi People’s Hospital from January 2020 to June 2021.The patients were divided into experimental group(Wenxin Keli+amiodarone)33 cases and control group(amiodarone)35 cases,according to their will.Wenxin Keli(9 g each time,3 times a day)were taken for 6 months,amiodarone(200 mg each time,3 times a day for the first week,2 times a day for the second week,once a day for the third week,and then maintained once a day)for 3 months.The 6-month QTc duration by electrocardiograph,left atrial size by echocardiography,atrial premature load of 24 h holter,incidence of adverse drug reaction,recurrence of AF,heart failure,stroke and death in 2 groups were observed.Results Compared with the control group,the left atrial diameter[(37.12±3.93)mm vs.(39.46±3.09)mm,P=0.008]and the atrial premature load of the dynamic electrocardiogram[(1.28±1.68)%vs.(3.54±6.08)%,P=0.041]of the experimental group was reduced after the treatment.Compared with before the treatment,the left atrial diameter[(39.91±3.20)mm vs.(37.12±3.93)mm,P=0.002]of the experimental group was reduced after the treatment.There was a significant difference in the incidence of AF recurrence between the two groups after the treatment(P=0.030),but there was no significant difference in the other events.Conclusions Wenxin Keli is safe and effective for AFpatients with atrial cardiomyopathy.It can reduce the recurrence of AF to a certain extent,improve atrial remodeling and the therapeutic effect.