论文部分内容阅读
目的探讨胺碘酮联合阿托伐他汀治疗老年冠心病伴阵发性心房颤动的临床疗效。方法选取沧州市黄骅市人民医院2014年12月—2016年11月收治的老年冠心病伴阵发性心房颤动患者82例,随机分为对照组和观察组,各41例。对照组患者给予胺碘酮治疗,观察组患者在对照组基础上给予阿托伐他汀治疗。比较两组患者治疗前后心率、血压(收缩压、舒张压)变化情况,治疗后3、12、24 h阵发性心房颤动转复情况,治疗6个月后阵发性心房颤动月发作次数及月发作总次数,临床疗效,治疗前后总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)变化情况及不良反应发生情况。结果治疗前,两组患者心率、收缩压、舒张压比较,差异无统计学意义(P>0.05);治疗后,两组患者心率比较,差异无统计学意义(P>0.05),观察组患者收缩压、舒张压低于对照组(P<0.05)。观察组患者治疗后3、12、24 h阵发性心房颤动转复率高于对照组(P<0.05)。治疗前,两组患者阵发性心房颤动月平均发作次数、月发作总次数比较,差异无统计学意义(P>0.05);治疗后,观察组患者阵发性心房颤动月平均发作次数、月发作总次数少于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05)。治疗前,两组患者TC、TG、LDL-C、hs-CRP水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者hs-CRP水平低于对照组(P<0.05);两组患者治疗后TC、TG、LDL-C、hs-CRP水平低于治疗前(P<0.05)。两组患者复律后不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用胺碘酮联合阿托伐他汀治疗老年冠心病伴阵发性心房颤动的临床疗效确切,可有效提高转复率,减少患者心房颤动发作次数,且安全性好。
Objective To investigate the clinical efficacy of amiodarone combined with atorvastatin in the treatment of elderly patients with coronary heart disease complicated with paroxysmal atrial fibrillation. Methods Eighty-two elderly patients with coronary heart disease and paroxysmal atrial fibrillation who were treated in Huanghua People’s Hospital of Cangzhou from December 2014 to November 2016 were randomly divided into control group and observation group, 41 cases in each group. Patients in the control group were treated with amiodarone. Patients in the observation group were given atorvastatin on the basis of the control group. The changes of heart rate, blood pressure (systolic blood pressure and diastolic blood pressure), the recovery of paroxysmal atrial fibrillation 3,12,24 h after treatment and the number of monthly paroxysmal atrial fibrillation episodes after 6 months of treatment were compared between the two groups The total number of monthly seizures, clinical curative effect, changes of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and hs-CRP before and after treatment and adverse reactions Happening. Results Before treatment, there was no significant difference in heart rate, systolic pressure and diastolic pressure between the two groups (P> 0.05). After treatment, there was no significant difference in heart rate between the two groups (P> 0.05) Systolic blood pressure and diastolic blood pressure were lower than those of the control group (P <0.05). The recovery rate of paroxysmal atrial fibrillation in observation group was higher than that in control group 3, 12 and 24 hours after treatment (P <0.05). Before treatment, the two groups of patients with paroxysmal atrial fibrillation, the average number of seizures, the total number of monthly seizures, the difference was not statistically significant (P> 0.05); after treatment, the observation group patients with paroxysmal atrial fibrillation monthly mean seizures months The total number of episodes was less than that of the control group (P <0.05). The clinical efficacy of the observation group was better than that of the control group (P <0.05). Before treatment, the levels of TC, TG, LDL-C and hs-CRP in the two groups had no significant difference (P> 0.05). After treatment, the hs-CRP level in the observation group was lower than that in the control group The levels of TC, TG, LDL-C and hs-CRP in the two groups were lower than those before treatment (P <0.05). There was no significant difference between the two groups in the incidence of adverse reactions after cardioversion (P> 0.05). Conclusion Amiodarone combined with atorvastatin is effective in treating elderly patients with coronary heart disease complicated with paroxysmal atrial fibrillation, which can effectively improve the recovery rate and reduce the number of patients with atrial fibrillation and has good safety.