目的 观察参松养心胶囊对心房颤动(房颤)患者导管射频消融术后复发的预防效果.方法 2014年2月-2015年10月武汉大学人民医院接受单次导管射频消融术的房颤住院患者80例作为研究对象,随机分为对照组(常规治疗)和观察组(常规治疗±参松养心胶囊)各40例.分别检查患者治疗前和治疗后6个月血液生化、24h动态心电图(Holter)和心脏彩色超声检查,并记录血清N末端脑钠肽前体(NT-proBNP)的变化情况,心功能参数左房内径(LAD)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、左室射血分数(LVEF)和舒张早期二尖瓣血流速度与舒张晚期二尖瓣血流速度比值(E/A)的改变、以及房颤早期的发作情况.结果 与治疗前相比,2组治疗后6个月NT-proBNP均降低[对照组:(474.0±122.4) ng/L vs.(363.53±117.91) ng/L;观察组:(466.6±125.1) ng/L vs.(263.58±84.35) ng/L],且观察组低于对照组(P均＜0.01).2组治疗后6个月LAD、LVEDD、LVESD均降低[对照组:(37.71±2.89)mm vs.(33.59±2.04) mm、(56.18±3.07) mm vs.(48.04±1.08)mm、(32.56±1.30) mm vs.(28.96±1.05)mm;观察组:(38.27±3.05) mm vs.(32.35±1.77) mm,(55.72±3.14) mm vs.(44.60±1.57) mm、(32.36±1.27)mm vs.(26.50±1.23) mm],且观察组低于对照组(P均＜0.01);LVEF、E/A升高[对照组:(59.6±4.6)％vs.(63.0±3.9)％、0.92±0.16 vs.1.27±0.13;观察组:(58.6±4.8)％vs.(64.7±4.3)％、0.92±0.12 vs.1.53±0.08],且观察组高于对照组(P=0.05);术后6个月内再发房颤患者:对照组11例(27.50％)高于观察组4例(10.00％)(x2=4.021,P=0.045).结论 参松养心胶囊能够有效地降低房颤患者射频消融术后的复发及NT-proBNP和左房内径.%Objective To observe the effects of Shensongyangxin capsule on recurrence after radiofrequency ablation in patients with atrial fibrillation (AF).Methods 80 patients with AF treated with radiofrequency ablation in Renmin Hospital of Wuhan University from February 2014 to October 2015 as researclh objects were enrolled and then randomly allocated to control group (conventional treatment) and observation group (conventional treatment plus Shensongyangxin capsule).Blood biochemistry test,24h Holter monitoring and echocardiography were examined in all patients before and 6 months after ablation,then recording N terminal pro brain natriuretic peptide (NT-proBNP),left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular ejection fraction (LVEF),early diastolic mitral flow velocity and diastolic mitral flow velocity ratio (E/A) and post ablation recurrence.Results Compared with pre-ablation,NT-proBNP was decreased in both groups after ablation [control group:(474.0 ± 122.4) ng/L vs.(363.53 ± 117.91) ng/L,observation group:(466.6 ± 125.1) ng/L vs.(263.58 ± 84.35) ng/L],and observation group was lower than control group(P ＜ 0.01).LAD was also decreased in both groups after ablation [control group:(37.71 ± 2.89) mm vs.(33.59± 2.04) mm,observation group:(38.27 ± 3.05) mm vs.(32.35 ± 1.77) mm],and observation group was lower than control(P =0.005).LVEDD was decreased in both groups after ablation[control group:(56.18 ±3.07) mm vs.(48.04 ± 1.08) mm,observation group:(55.72 ± 3.14) mmvs.(44.60 ± 1.57) mm],and observation group was lower than control group(P =0.004).LVESD was decreased in both groups after ablation[control group:(32.56 ± 1.30) mm vs.(28.96 ± 1.05) mm,observation group:(32.36 ± 1.27) mm vs.(26.50 ± 1.23) mm],observation group was lower than control group (P =0.005).LVEF was increased in both groups after ablation [control group:(59.6 ± 4.6) ％ vs.(63.0 ± 3.9) ％,observation group:(58.6 ±4.8) ％ vs.(64.7 ±4.3) ％],observation group was higher than control group (P =0.004).E/A was also increased in both groups after ablation [control group:(0.92 ± 0.16) vs.(1.27 ± 0.13),observation group:(0.92 ± 0.12) vs.(1.53 ±0.08)],observation group was higher than control group(P =0.005).Postablation recurrence was recorded in 11 cases (27.50％) in control group and 4 cases in observation group (10.00％).There were statistical significance in recurrence rate between the two groups (P =0.045).Conclusion Shensongyangxin capsule could effectively reduce AF recurrence after radiofrequency ablation,meanwhile,lowering NT-proBNP and LAD 6 months after ablation.
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