决奈达隆治疗阵发性心房颤动的疗效观察

Effect observation of dronedarone in the treatment of patients with paroxysmal atrial fibrillation

目的 观察决奈达隆治疗阵发性心房颤动的疗效及安全性。方法 将56例阵发性心房颤动患者随机分为治疗组29例和对照组27例。2组患者入组前均行相关评估并排除抗凝禁忌证,而后给予常规抗凝治疗;治疗组患者口服盐酸决奈达隆片,连续治疗3个月。比较2组患者治疗前后的心房颤动发作次数、单次心房颤动发作最长持续时间、窦性静息心率变化、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVDd)、左房内径(LAD)、N端脑钠肽前体(NT-proBNP)]、不良反应情况。结果 治疗后,治疗组患者心房颤动发作总次数、窦性静息心率较治疗前降低,心房颤动发作最长持续时间缩短,差异有统计学意义(P<0.05);治疗后,治疗组患者心房颤动发作总次数、窦性静息心率较对照组降低,心房颤动发作最长持续时间较对照组缩短,差异有统计学意义(P<0.05)。治疗后,治疗组LVEF较治疗前升高,LVDd、LAD、NT-proBNP较治疗前下降,差异有统计学意义(P<0.05);治疗后,治疗组LVEF较对照组升高,LVDd、LAD、NT-proBNP较对照组下降,差异有统计学意义(P<0.05)。治疗后,对照组不良反应发生率为7.41%,治疗组为6.90%,差异无统计学意义(P>0.05)。结论 决奈达隆可以有效控制阵发性心房颤动患者的心室率,缩短心房颤动发作持续时间,减少心房颤动发作次数,维持窦性心律,改善心功能指标,且不良反应小。

Objective To observe the efficacy and safety of dronedarone in the treatment of patients with paroxysmal atrial fibrillation.Methods A total of 56 patients with paroxysmal atrial fibrillation were randomly divided into treatment group with 29 cases and control group with 27 cases.Patients in both groups were conducted with relevant assessments before enrollment,the contraindications to anticoagulation were also excluded,and then routine anticoagulation therapy was performed;the patients in the treatment group took dronedarone hydrochloride tablets orally for three consecutive months.Before and after treatment,number of times of atrial fibrillation attack,the maximum duration of a single atrial fibrillation attack,change of sinus resting heart rate,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVDd),left atrial diameter(LAD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)]and adverse reactions were compared between two groups.Results After treatment,the total number of times of atrial fibrillation attack and sinus resting heart rate in the treatment group decreased significantly when compared to those before treatment,and the longest duration of atrial fibrillation attack shortened significantly(P<0.05);after treatment,the total number of times of atrial fibrillation attack and sinus resting heart rate in the treatment group were significantly lower than those in the control group,and the longest duration of atrial fibrillation attack was significantly shorter than that in the control group(P<0.05).After treatment,LVEF in the treatment group increased significantly when compared to that before treatment,while LVDd,LAD and NT-proBNP decreased significantly when compared to those before treatment(P<0.05);after treatment,LVEF in the treatment group was significantly higher than that in the control group,while LVDd,LAD and NT-proBNP were significantly lower than those in the control group(P<0.05).After treatment,the incidence of adverse reactions in the control group was 7.41%,which showed no significant difference when compared to 6.90%in the treatment group(P>0.05).Conclusion Dronedarone can effectively control the ventricular rate of patients with paroxysmal atrial fibrillation,shorten the duration of atrial fibrillation attack,reduce the frequency of atrial fibrillation attack,maintain sinus rhythm,improve cardiac function indicators,and cause less adverse reactions.