CAJ | 학술논문

目的：探讨瑞舒伐他汀对消融术后早期炎性反应及术后早期复发的影响。方法连续入选84例拟行导管消融术的持续性心房颤动（房颤）患者，随机分为两组：A组42例给予瑞舒伐他汀10 mg/d；B组42例为空白对照组。随访术后1个月患者的血脂水平、血清高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）以及患者消融术后1个月内的复发率。比较消融术前、术后以及两组间炎性指标变化及其与术后早期复发的关系。结果消融术后1个月时，A组的hs-CRP及IL-6水平显著低于B组，且明显低于治疗前；而B组hs-CRP及IL-6水平较术前显著增高。术后1个月，A组和B组分别有29例和25例患者成功维持窦性心律（P=0.362）；进一步将A组分为未复发组和复发组，未复发组的炎性指标降低幅度较大，但差异无统计学意义。结论消融术后早期存在显著的炎性反应。瑞舒伐他汀虽能有效降低炎性反应，但仅有减少术后早期复发的趋势。炎症指标降低越多房颤复发率越低，但差异无统计学意义。
목적：탐토서서벌타정대소융술후조기염성반응급술후조기복발적영향。방법련속입선84례의행도관소융술적지속성심방전동（방전）환자，수궤분위량조：A조42례급여서서벌타정10 mg/d；B조42례위공백대조조。수방술후1개월환자적혈지수평、혈청고민C반응단백（hs-CRP）、백세포개소-6（IL-6）이급환자소융술후1개월내적복발솔。비교소융술전、술후이급량조간염성지표변화급기여술후조기복발적관계。결과소융술후1개월시，A조적hs-CRP급IL-6수평현저저우B조，차명현저우치료전；이B조hs-CRP급IL-6수평교술전현저증고。술후1개월，A조화B조분별유29례화25례환자성공유지두성심률（P=0.362）；진일보장A조분위미복발조화복발조，미복발조적염성지표강저폭도교대，단차이무통계학의의。결론소융술후조기존재현저적염성반응。서서벌타정수능유효강저염성반응，단부유감소술후조기복발적추세。염증지표강저월다방전복발솔월저，단차이무통계학의의。
Objective To investigate the value of rosuvastatin in alleviating early inflammatory reaction and in preventing early recurrence of persistent atrial fibrillation (AF) after catheter ablation treatment. Methods A total of 84 patients with persistent AF who had received catheter ablation were enrolled in this study. The patients were randomly and equally divided into group A (n = 42, study group) and group B (n = 42, control group). Rosuvastatin therapy (10 mg/d, 42 patients) was employed in the patients of group A, while no medication was used in the patients of group B. One month after the ablation treatment, the serum lipid level, hs-CRP and IL-6, as well as the recurrence rate of all kinds of arrhythmia were determined. The preoperative and postoperative levels of inflammatory markers were also determined, the results were compared between the two groups, and its correlation with the early recurrence of AF was evaluated. Results One month after the ablation treatment, the levels of inflammatory markers, including hs-CRP and IL-6, in the study group were significantly lower than those in the control group, as well as lower than those determined before treatment, while in the control group the serum hs-CRP and IL-6 levels became significantly higher than the preoperative ones. Sinus rhythm was successfully maintained in 29 cases (69%) of the study group and in 25 cases (59.5%) of the control group, while the difference was not statistically significant (P = 0.362). The patients of the study group were further divided into non-recurrence sub-group (n = 29) and recurrence sub-group (n = 13). The reduction in inflammatory marker level in the non-recurrence sub-group was greater than that in the recurrence sub-group although the difference was not statistically significant. Conclusion There is remarkable inflammatory reactions during the early period after catheter ablation. Rosuvastatin can effectively relieve the degree of inflammatory reaction, although it has only a slight effect in reducing the early recurrence rate after catheter ablation of AF. The greater the inflammatory markers levels are reduced, the lower the recurrence rate of AF will be, although the difference is not statistically significant.