糖皮质激素对阵发性心房颤动射频消融术后复发的影响

发布时间：2018-10-10 10:02

【摘要】：目的：探讨糖皮质激素的使用对阵发性心房颤动患者导管射频消融术后房颤复发的影响。方法：本研究连续入选从2011年1月至2014年4月在我院心内科行环肺静脉射频消融术,并在术后使用糖皮质激素的阵发性心房颤动患者50例,并选取同期行射频消融术,术后未使用糖皮质激素的阵发性心房颤动患者37例作对照组。术后1周、1个月、3个月、6个月、9个月、12个月,由固定医生进行电话或门诊随访,询问患者有无心悸症状或脉搏不齐,收集病人院外心电图报告,行十二导联心电图和24小时动态心电图检查,分析、比较激素治疗组和对照组的房颤复发情况。结果：1.术后1周,激素治疗组和对照组窦性心律百分比分别为80.0%和54.1%,p0.05,激素治疗组复发显著降低；术后1个月,激素组和对照组保持窦性心律百分比分别为80.0%和67.6%,p=0.187,复发率无明显统计学差异；2.绘制Kaplan-Meier生存率曲线,行log-rank检验,p=0.711,激素组和对照组术后12个月的房颤复发率无明显统计学差异。结论：小剂量糖皮质激素使用能够降低射频消融术后超早期(7日内)的房颤复发,但并不能降低术后极早期(1月)和中期(12月)房颤复发。
[Abstract]:Objective: to investigate the effect of glucocorticoid on the recurrence of atrial fibrillation in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation. Methods: from January 2011 to April 2014, 50 patients with paroxysmal atrial fibrillation treated with glucocorticoid were enrolled in this study. 37 patients with paroxysmal atrial fibrillation without glucocorticoid were used as control group. One week, one month, three months, six months, nine months, twelve months after operation, the patients were followed up by telephone or outpatient by fixed doctors, asked if they had palpitation symptoms or irregular pulse, and the electrocardiogram reports were collected. Twelve-lead electrocardiogram and 24-hour ambulatory electrocardiogram were performed to compare the recurrence of atrial fibrillation in the hormone treatment group and the control group. The result is 1: 1. The percentage of sinus rhythm in the hormone treatment group and the control group was 80.0% and 54.1%, respectively. The recurrence rate in the hormone treatment group was significantly lower than that in the control group (P 0.05), and the recurrence rate in the hormone treatment group was significantly lower than that in the control group. The percentage of sinus rhythm maintained in the hormone group and the control group was 80.0% and 67.6%, respectively. There was no significant difference in the recurrence rate between the hormone group and the control group. The survival rate curve of Kaplan-Meier was drawn and log-rank test was performed. There was no significant difference in the recurrence rate of atrial fibrillation between the hormone group and the control group at 12 months after operation. Conclusion: the use of low dose glucocorticoid can reduce the recurrence of atrial fibrillation in the early (7 days) after radiofrequency ablation, but not in the very early (1 month) and middle (12 months) after radiofrequency ablation.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.75

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