CAJ | 학술논문

目的：比较心率控制和射频消融节律控制治疗心力衰竭(心衰)合并心房颤动(房颤)患者的疗效。方法在Pubmed、EMBASE、中国知网及万方数据库中检索1990年1月至2014年3月发表的比较心率控制与节律控制治疗心衰合并房颤患者的随机对照研究,并应用Revman 5．1及Stata 12．0对其进行分析,分析的主要事件为随访结束时的左心室射血分数( LVEF )、左心室收缩末期容积(LVESV)、6 min步行试验(6-MWT)及生活质量评分(QoL)。结果4项研究最终入组,包括224例合并房颤的心衰患者。荟萃( meta)分析提示与心率控制相比,射频消融节律控制可以显著改善 LVEF (WMD 6．61,95% CI 4．49~8．74)、LVESV(WMD -16．26,95% CI -30．26~-2．26)、6-MWT(WMD 36．88,95% CI 12．72~61．04)及QoL(WMD -14．05,95% CI -22．03~-6．07),差异有统计学意义。结论心衰合并房颤患者选择射频消融节律控制治疗可以提高左心室功能、逆转心肌重构、提高运动耐量并且改善生活质量。
목적：비교심솔공제화사빈소융절률공제치료심력쇠갈(심쇠)합병심방전동(방전)환자적료효。방법재Pubmed、EMBASE、중국지망급만방수거고중검색1990년1월지2014년3월발표적비교심솔공제여절률공제치료심쇠합병방전환자적수궤대조연구,병응용Revman 5．1급Stata 12．0대기진행분석,분석적주요사건위수방결속시적좌심실사혈분수( LVEF )、좌심실수축말기용적(LVESV)、6 min보행시험(6-MWT)급생활질량평분(QoL)。결과4항연구최종입조,포괄224례합병방전적심쇠환자。회췌( meta)분석제시여심솔공제상비,사빈소융절률공제가이현저개선 LVEF (WMD 6．61,95% CI 4．49~8．74)、LVESV(WMD -16．26,95% CI -30．26~-2．26)、6-MWT(WMD 36．88,95% CI 12．72~61．04)급QoL(WMD -14．05,95% CI -22．03~-6．07),차이유통계학의의。결론심쇠합병방전환자선택사빈소융절률공제치료가이제고좌심실공능、역전심기중구、제고운동내량병차개선생활질량。
Objective To evaluate the efficiency of rhythm control ( RhC) using catheter ablation and rate control ( RaC) for atrial fibrillation in patients with heart failure. Methods The Pubmed,EMBASE,CNKI and Wanfang Data were searched for randomized controlled trials published from January,1990 to March 2014. Revman 5. 1and Stata 12. 0 were used to perform this meta-analysis and the main outcomes were left ventricular ejection fraction (LVEF),left ventricular end-systolic volume (LVESV),6 min walking test (6-MWT) and quality of life (QoL). Results Four studies were included,and we got 224 patients for the final analyses. Meta-analysis demonstrated that RhC can improve LVEF (WMD 6. 61,95% CI 4. 49~8. 74),LVESV (WMD-16. 26,95% CI -30. 26~-2. 26),6-MWT (WMD 36. 88,95% CI 12. 72~61. 04) and QoL (WMD-14. 05, 95% CI-22. 03~-6. 07) when compared with RaC. Conclusions Catheter ablation for RhC is better than RaC for the improvement of LVEF,LVESV,6-MWT and QoL in patients with heart failure and atrial fibrillation.