CAJ | 학술논문

目的探讨射频消融术能否纠正左心室功能失调.方法将符合入组标准的患者49例分成射频消融组(35例)和对照组(14例).射频消融组患者行射频消融治疗,对照组患者接受药物干预.患者均随访3～6个月,评估2组患者室性期前收缩负荷(PVC)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及左心室收缩末期内径(LVESD)等情况.结果治疗前射频消融组与对照组PVC、LVEF、LVEDD、LVESD差异均无统计学意义[(24±11)％比(21±7)％；(63±9)％比(60±6)％；(50±4) mm比(49±5)mm; (32±5)mm比(34 ±3) mm;均P＞0.05].治疗后射频消融组PVC明显减低[(8±11)％比(24±11)％,t =6.149,P＜0.01],LVEF明显增高[(68±5)％比(63±9)％,t=3.426,P＜0.01],LVEDD明显减小[(48±3)mm比(50±4)mm,t=3.539,P＜0.01],LVESD明显减小[(3l±3)mm比(32±5)mm,t=2.665,P ＜0.05].对照组治疗后PVC增高[(22±5)％比(21±7)％,t=3.180,P＜0.05],LVEF减低[(59±5)％比(60±6)％,t=2.754,P＜0.05],LVEDD增加[(50±5)mm比(49 ±5)mm,t =5.551,P＜0.01],LVESD增加[(35 ±3)mm比(34±3)mm,t=2.599,P＜0.05].射频消融组治疗后PVC、LVEF、LVESD与对照组治疗后比较差异均有统计学意义(均P＜0.01).结论频发室性早搏的患者更易发生左心室扩大和收缩功能失调.对药物治疗不满意的频发室性早搏患者通过射频导管消融治疗可以获得满意的疗效.对有适应证者应尽早行射频消融术根治.
목적 탐토사빈소융술능부규정좌심실공능실조.방법 장부합입조표준적환자49례분성사빈소융조(35례)화대조조(14례).사빈소융조환자행사빈소융치료,대조조환자접수약물간예.환자균수방3～6개월,평고2조환자실성기전수축부하(PVC)、좌심실사혈분수(LVEF)、좌심실서장말기내경(LVEDD)급좌심실수축말기내경(LVESD)등정황.결과 치료전사빈소융조여대조조PVC、LVEF、LVEDD、LVESD차이균무통계학의의[(24±11)％비(21±7)％；(63±9)％비(60±6)％；(50±4) mm비(49±5)mm; (32±5)mm비(34 ±3) mm;균P＞0.05].치료후사빈소융조PVC명현감저[(8±11)％비(24±11)％,t =6.149,P＜0.01],LVEF명현증고[(68±5)％비(63±9)％,t=3.426,P＜0.01],LVEDD명현감소[(48±3)mm비(50±4)mm,t=3.539,P＜0.01],LVESD명현감소[(3l±3)mm비(32±5)mm,t=2.665,P ＜0.05].대조조치료후PVC증고[(22±5)％비(21±7)％,t=3.180,P＜0.05],LVEF감저[(59±5)％비(60±6)％,t=2.754,P＜0.05],LVEDD증가[(50±5)mm비(49 ±5)mm,t =5.551,P＜0.01],LVESD증가[(35 ±3)mm비(34±3)mm,t=2.599,P＜0.05].사빈소융조치료후PVC、LVEF、LVESD여대조조치료후비교차이균유통계학의의(균P＜0.01).결론 빈발실성조박적환자경역발생좌심실확대화수축공능실조.대약물치료불만의적빈발실성조박환자통과사빈도관소융치료가이획득만의적료효.대유괄응증자응진조행사빈소융술근치.
Objective To explore whether radiofrequency catheter ablation can reverse left ventricular dysfunction.Methods Totally 35 patients for radiofrequency catheter ablation (RFCA) and 14 patients who took antiarrhythmic drugs but did not accept radiofrequency catheter ablation were enrolled.All patients were evaluated at baseline and 3-6 months followed up in terms of premature ventricular complexes (PVC),left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic diameter (LVESD).Results The patients in both RFCA group and control group were matched in PVC,LVEF,LVEDD and LVESD at baseline [(24 ± 1 1) ％ vs (21 ± 7) ％ ; (63 ± 9) ％ vs (60 ± 6) ％ ; (50 ± 4) mm vs (49 ± 5) mm;(32 ±5)mm vs (34 ±3)mm; all P ＞0.05].Compared to baseline,the patients in the RFCA group showed significantly decreased PVC [(8 ± 11) ％ vs (24 ± 11) ％,t =6.149,P ＜ 0.01],increased LVEF [(68 ± 5) ％ vs (63 ± 9) ％,t =3.426,P ＜ 0.01] and decreased LVEDD and LVESD [(50 ± 4) mm vs (48 ± 3) mm,t =3.539,P ＜ 0.01 ; (31 ± 3) mm vs (32 ± 5) mm,t =2.665,P ＜ 0.05].However,the patients in the control group showed significantly increased PVC [(22 ± 5) ％ vs (21 ± 7) ％,t =3.180,P ＜ 0.05],decreased LVEF [(59 ± 5) ％ vs (60 ±6)％,t =2.754,P＜0.05],and increased LVEDD and LVESD[(50 ±5)mm vs (49 ±5)mm,t =5.551,P ＜ 0.05 ; (35 ± 3) mm vs (34 ± 3) mm,t =2.599,P ＜ 0.05].Conclusion Idiopathic PVGs may represent a form of cardiomyopathy that can be reversed by catheter ablation of the PVCs.