缬沙坦与螺内酯对房颤射频消融术后患者机体炎症指标、Hcy及Cys-C水平的影响

Effects of valsartan and spironolactone on inflammatory indexes,Hcy and Cys-C levels in patients with atrial fibrillation after radiofrequency ablation

目的 比较缬沙坦与螺内酯对房颤射频消融术后患者机体炎症指标、同型半胱氨酸(Hcy)及胱抑素C(Cys-C)水平的影响。方法 选取2020年1月至2021年4月我院收治的92例房颤患者为研究对象,随机将其分为A组(46例,常规治疗+缬沙坦)与B组(46例,常规治疗+螺内酯)。比较两组的治疗效果。结果 B组的治疗总有效率为97.83%,高于A组的82.61%(P<0.05)。术后6个月,两组的左房内径(LAD)、左房容积(LAV)均明显减小,且B组小于A组(P<0.05)。术后6个月,两组的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及C-反应蛋白(CRP)水平均明显降低,且B组低于A组(P<0.05)。术后6个月,两组的Hcy、Cys-C水平均明显降低,且B组低于A组(P<0.05)。B组术后6个月的复发率低于A组(P<0.05)。结论 螺内酯在房颤射频消融术后患者中的应用效果较缬沙坦显著,其可有效缩小患者的左心房,改善机体的炎症指标及Hcy、Cys-C水平,降低房颤复发率。

Objective To compare the effects of valsartan and spironolactone on inflammatory indexes,homocysteine(Hcy)and cystatin C(Cys-C)levels in patients with atrial fibrillation after radiofrequency ablation.Methods A total of 92 patients with atrial fibrillation admitted in our hospital from January 2020 to April 2021 were selected as the research objects,and the patients were randomly divided into group A(46 cases,routine treatment+valsartan)and group B(46 cases,routine treatment+spironolactone).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the group B was 97.83%,which was higher than 82.61%in the group A(P<0.05).At 6 months after operation,the left atrial diameter(LAD)and left atrial volume(LAV)in the two groups significantly decreased,and those in the group B were less than the group A(P<0.05).At 6 months after operation,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)in the two groups significantly decreased,and those in the group B were lower than the group A(P<0.05).At 6 months after operation,the levels of Hcy and Cys-C in the two groups significantly decreased,and those in the group B were lower than the group A(P<0.05).The recurrence rate of the group B was lower than that of the group A at 6 months after operation(P<0.05).Conclusion The spironolactone in patients with atrial fibrillation after radiofrequency ablation has more significant application effect than that of valsartan.It can effectively reduce the left atrium of patients,improve the inflammatory indexes of the body and the levels of Hcy and Cys-C,and reduce the recurrence rate of atrial fibrillation.