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目的探讨氟伐他汀对阵发性心房颤动复发的预防作用。方法阵发性心房颤动患者118例,随机分为氟伐他汀组61例和对照组57例,对照组采用常规治疗,氟伐他汀组在常规治疗基础上加用氟伐他汀80mg口服,1次/d。2组分别于治疗前、治疗1周及随访24个月时采用免疫比浊法测定血清C反应蛋白水平,采用ELISA法测定血清同型半胱氨酸水平。治疗前及随访24个月时行心脏超声检查,测定2组患者左心房前后径、左心室舒张末期内径和左室射血分数。随访24个月,观察2组阵发性心房颤动复发、阵发性心房颤动进展为永久性心房颤动、心力衰竭、脑卒中等发生情况。结果氟伐他汀组阵发性心房颤动复发率(24.59%)和心力衰竭发生率(6.55%)明显低于对照组(49.12%、19.29%)(P<0.05),阵发性心房颤动进展为永久性心房颤动发生率(8.19%)、脑卒中发生率(6.55%)与对照组(12.28%、8.77%)比较差异均无统计学意义(P>0.05);治疗1周和随访24个月时,氟伐他汀组血清C反应蛋白[(1.34±0.91)、(0.73±0.32)mg/L]和同型半胱氨酸[(11.79±2.79)、(11.41±3.12)μmol/L]水平均明显低于治疗前[(2.58±1.91)mg/L、(16.93±5.81)μmol/L]和对照组[(1.70±0.91)、(0.98±0.74)mg/L,(15.05±4.81)、(14.65±8.21)μmol/L](P<0.05);随访24个月时,氟伐他汀组左心房前后径、左心室舒张末期内径、左室射血分数与治疗前和对照组比较差异均无统计学意义(P>0.05)。结论氟伐他汀治疗可减少阵发性心房颤动复发和心力衰竭的发生。
Objective To investigate the preventive effect of fluvastatin on the recurrence of paroxysmal atrial fibrillation. Methods A total of 118 patients with paroxysmal atrial fibrillation were randomly divided into fluvastatin group (n = 61) and control group (n = 57). The control group received routine treatment. Fluvastatin group was given oral fluvastatin 80 mg / d. Serum C-reactive protein levels were measured by immunoturbidimetry before treatment, 1 week after treatment and 24 months after treatment. Serum homocysteine level was measured by ELISA. Echocardiography was performed before treatment and at 24 months of follow-up. Left atrium anteroposterior diameter, left ventricular end-diastolic diameter and left ventricular ejection fraction were measured in two groups. The patients were followed up for 24 months. The recurrence of paroxysmal atrial fibrillation was observed in two groups. The progression of paroxysmal atrial fibrillation was permanent atrial fibrillation, heart failure and stroke. Results The recurrence rate of paroxysmal atrial fibrillation (24.59%) and heart failure (6.55%) in fluvastatin group were significantly lower than those in control group (49.12%, 19.29%) (P <0.05). The progression of paroxysmal atrial fibrillation was The incidence of permanent atrial fibrillation (8.19%) and stroke (6.55%) was not significantly different from that of the control group (12.28%, 8.77%) (P> 0.05) (1.34 ± 0.91), (0.73 ± 0.32) mg / L] and homocysteine [(11.79 ± 2.79), (11.41 ± 3.12) μmol / L] in the fluvastatin group Was significantly lower than that before treatment [(2.58 ± 1.91) mg / L, (16.93 ± 5.81) μmol / L and control group [1.70 ± 0.91 vs 0.98 ± 0.74 mg / L, 14.65 ± 8.21) μmol / L] (P <0.05). At 24 months of follow-up, there was no significant difference in the anteroposterior diameter, left ventricular end-diastolic diameter and left ventricular ejection fraction between the fluvastatin group and the control group Statistical significance (P> 0.05). Conclusion Fluvastatin treatment can reduce the recurrence of paroxysmal atrial fibrillation and heart failure.