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螺内酯在心房颤动射频消融术后的应用研究

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目的:分析螺内酯对心房颤动(AF)射频消融术(RFA)患者心肌纤维化指标及基质金属蛋白酶(MMP)家族成员表达水平的影响。方法:选取 2020 年 12 月至 2023 年 3 月郑州大学第一附属医院收治的 68 例接受RFA治疗的AF患者,根据用药方法不同分为对照组和观察组,各 34 例。对照组术后予以胺碘酮治疗,观察组在对照组基础上加用螺内酯治疗。比较两组患者心肌纤维化指标、MMP家族水平、炎症指标、不良反应发生情况。结果:术后3个月,两组患者层粘连蛋白(LN)、Ⅲ型前胶原氨基端原肽(PⅢNP)、醛固酮水平低于术前,且观察组低于对照组,差异具有统计学意义(P<0。05)。术后 3个月,两组患者血清MMP-2、MMP-9 水平低于术前,且观察组低于对照组,差异具有统计学意义(P<0。05)。术后 3 个月,两组患者血清C反应蛋白(CRP)、白细胞介素-6(IL-6)水平低于术前,且观察组低于对照组,差异具有统计学意义(P<0。05)。两组患者不良反应发生率比较,差异无统计学意义(P>0。05)。结论:螺内酯可改善AF患者RFA术后的心肌纤维化,调节MMP家族成员表达水平,抑制炎症因子表达,且用药安全性较高。
Study on the Application of Spironolactone after Radiofrequency Ablation of Atrial Fibrillation
Objective To analyze the effects of spironolactone on myocardial fibrosis indexes and matrix metalloproteinase(MMP)family level in patients with atrial fibrillation(AF)after radiofrequency ablation(RFA).Methods Sixty-eight AF patients treated with RFA in the First Affiliated Hospital of Zhengzhou University from December 2020 to March 2023 were selected and divided into a control group(34 cases)and an observation group(34 cases)according to the method of medication.Myocardial fibrosis indexes,MMP family level,inflammation indexes and adverse reactions were compared between the two groups.Results Three months after surgery,the levels of laminin(LN),N-terminal propeptide of type Ⅲ procollagen(PⅢNP)and aldosterone in the two groups were lower than those before surgery,and the levels of the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Three months after surgery,the levels of serum MMP-2 and MMP-9 in the two groups were lower than those before surgery,and the levels of the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Three months after surgery,the levels of serum C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups were lower than those before surgery,and the levels of the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Spironolactone can improve myocardial fibrosis after RFA in AF patients,regulate the level of MMP family,inhibit the expression of inflammatory factors,and has high safety.

Atrial fibrillationRadiofrequency ablationSpironolactoneAmiodarone

闫佩佩、陈雅丽、白雪洋

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郑州大学第一附属医院,河南 郑州 450000

心房颤动 射频消融术 螺内酯 胺碘酮

河南省医学科技攻关计划联合共建项目

LHGJ20190098

2024

深圳中西医结合杂志
深圳市中西医结合临床研究所

深圳中西医结合杂志

影响因子:0.692
ISSN:1007-0893
年,卷(期):2024.34(2)
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