CAJ | 학술논문

目的对比药物治疗与导管消融对心房颤动(房颤)患者左心房结构、功能及生活质量的影响.方法 2012年1月至2013年6月在第三军医大学西南医院心血管内科住院的200例未行导管消融的房颤患者,年龄17～83(56.27±12.98)岁,病程2～68(14.12±11.25)个月.其中72例接受药物治疗(A组),128例接受三维电解剖标测系统(Carto)指导下消融治疗(B组),随访3、6个月后对两组患者的左心房结构、功能及生活质量进行比较.结果经过3个月的随访,A组有69例完成随访,21例维持窦性心律(窦律)(30.4％).B组有127例完成随访,108例患者维持窦律(85.0％).独立样本t检验提示:A组的左心室收缩末期左心房最大容积指数(LAVImax)与左心室舒张末期左心房最小容积指数(LAVImin)增大,左心房射血分数(LAEF)减小;B组的LAVImax与LAVImin减小,LAEF增加.A组与B组的一般健康与生活质量明显提高,但B组提高的幅度明显高于A组,3个月后两组的一般健康与生活质量差异有统计学意义(P＜0.01);A组与B组的心理健康评分均明显增加(P＜0.01),但两组提高的水平差异无统计学意义.经过6个月的随访,A组的LAVImax、LAVImin较3个月前明显增大,LAEF明显减少(P＜0.05),但B组的LAVImax,LAVImin较3个月前略有缩小,LAEF略有增加,差异无统计学意义.A组的一般健康与生活质量、心理健康评分较3个月前明显降低(P＜0.05),但B组的一般健康与生活质量、心理健康评分与3个月前相比差异无统计学意义.结论导管消融在改善房颤患者的左心房大小、功能及提高生活质量方面优于药物治疗.
목적 대비약물치료여도관소융대심방전동(방전)환자좌심방결구、공능급생활질량적영향.방법 2012년1월지2013년6월재제삼군의대학서남의원심혈관내과주원적200례미행도관소융적방전환자,년령17～83(56.27±12.98)세,병정2～68(14.12±11.25)개월.기중72례접수약물치료(A조),128례접수삼유전해부표측계통(Carto)지도하소융치료(B조),수방3、6개월후대량조환자적좌심방결구、공능급생활질량진행비교.결과 경과3개월적수방,A조유69례완성수방,21례유지두성심률(두률)(30.4％).B조유127례완성수방,108례환자유지두률(85.0％).독립양본t검험제시:A조적좌심실수축말기좌심방최대용적지수(LAVImax)여좌심실서장말기좌심방최소용적지수(LAVImin)증대,좌심방사혈분수(LAEF)감소;B조적LAVImax여LAVImin감소,LAEF증가.A조여B조적일반건강여생활질량명현제고,단B조제고적폭도명현고우A조,3개월후량조적일반건강여생활질량차이유통계학의의(P＜0.01);A조여B조적심리건강평분균명현증가(P＜0.01),단량조제고적수평차이무통계학의의.경과6개월적수방,A조적LAVImax、LAVImin교3개월전명현증대,LAEF명현감소(P＜0.05),단B조적LAVImax,LAVImin교3개월전략유축소,LAEF략유증가,차이무통계학의의.A조적일반건강여생활질량、심리건강평분교3개월전명현강저(P＜0.05),단B조적일반건강여생활질량、심리건강평분여3개월전상비차이무통계학의의.결론 도관소융재개선방전환자적좌심방대소、공능급제고생활질량방면우우약물치료.
Objective To compare the effects of antiarrhythmic drug therapy with catheter ablation for atrial fibrillation (AF) on left atrial structure,function and quality of life.Methods Two hundred AF patients [mean age (56.27±12.98) years] were included in this study,72 cases with drug treatment (group A),128 cases with Carto guided-catheter ablation (group B).Mter 3-month follow-up and 6-month follow-up,the left atrial structure,function and life quality of life were compared between group A and group B.Results During 3-month follow-up,21 patients maintained sinus rhythm (30.4％) in group A,and 108 patients maintained sinus rhythm (85.0％) in group B.Independent sample t test showed maximal left atrial votume index(LAVImax) and miminal left atrial votume index (LAVImin) increased and left atrial ejection fraction (LAEF) decreased in group A,LAVImax and LAVImin decreased and LAEF increased in group B.General health and quality of life was improved significantly in both two groups,group B was better than group A(P＜0.01).Mental health scores were also significantly increased in both two groups(P＜0.01)with no difference between two groups.After 6-month follow-up,LAVImax and LAVImin was increased and LAEF was decreased significantly when cornpared with 3-month follow-up in group A(P＜0.05),while LAVImax and LAVImin decreased and LAEF increased in group B.General health,quality of life and mental health scores were decreased significantly compared with 3-month follow-up in group A (P＜ 0.05),but no statistical differences in group B.Conclusion Catheter ablation is better than drug therapy in improving left atrial size,function and quality of life.