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在伴有心房颤动和无症状性心房颤动的心脏起搏患者中的炎症细胞因子。

Inflammatory cytokines in cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation.

机构信息

Department of Cardiology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian, China.

Department of Cardiology, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Panminerva Med. 2018 Sep;60(3):86-91. doi: 10.23736/S0031-0808.18.03452-3. Epub 2018 Apr 24.

Abstract

BACKGROUND

To investigate the changes of inflammatory cytokines in cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation and the effects of metoprolol on them.

METHODS

A total of 92 cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation in our hospital from April 2015 to March 2017 were selected and randomly divided into the control group and the observation group, with 46 cases in each group. Three months after pacemaker implantation, the control group was treated with aspirin, the observation group was treated with metoprolol on the basis of aspirin, and the curative effects were compared between the two groups. After treatment, the heart rate, the frequency and duration of atrial fibrillation and the atrial fibrillation load were observed. P-wave dispersion (PD) and cardiac function of the two groups of patients at 6 months after treatment were compared. The changes of serum levels of tumor necrosis factor-α (TNF-α), high sensitive C-reactive protein (Hs-CRP) and interleukin-6 (IL-6) in patients were compared before treatment and at 1, 3 and 6 months after treatment. The quality of life of the two groups of patients was observed.

RESULTS

After treatment, the effective rate of treatment in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the average heart rate and atrial fibrillation load in the observation group were significantly improved compared with those in the control group, and the frequency and duration of atrial fibrillation were significantly lower than those in the control group (P<0.05). After treatment, the maximum P-wave duration (Pmax), the minimum P-wave duration (Pmin) and PD in the observation group were significantly lower than those in the control group (P<0.05). The left ventricular ejection fraction (LVEF) in the observation group was significantly higher than that in the control group, and the left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and E/A in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of TNF-α, Hs-CRP and IL-6 in the two groups of patients were decreased significantly, and those in the observation group were significantly lower than those in the control group (P<0.05). The quality of life score in the observation group was significantly higher than that in the control group (P<0.05).

CONCLUSIONS

Metoprolol can effectively reduce the incidence of atrial fibrillation, atrial fibrillation loadand inflammatory cytokine levels in cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation, and improve cardiac function of the patients and their quality of life. It has an important clinical significance.

摘要

背景

探讨心脏起搏患者伴或不伴无症状心房颤动时炎症细胞因子的变化,以及美托洛尔对此的影响。

方法

选取 2015 年 4 月至 2017 年 3 月我院收治的 92 例心脏起搏伴心房颤动和无症状心房颤动患者,随机分为对照组和观察组,每组 46 例。起搏器植入 3 个月后,对照组给予阿司匹林治疗,观察组在阿司匹林基础上加用美托洛尔治疗,比较两组疗效。观察两组患者治疗后心率、心房颤动的发作频率、持续时间及心房颤动负荷;比较两组患者治疗后 6 个月 P 波离散度(PD)和心功能;比较两组患者治疗前后血清肿瘤坏死因子-α(TNF-α)、高敏 C 反应蛋白(Hs-CRP)和白细胞介素-6(IL-6)水平的变化;观察两组患者的生活质量。

结果

观察组治疗总有效率明显高于对照组(P<0.05)。观察组治疗后平均心率及心房颤动负荷较对照组明显改善,心房颤动发作频率及持续时间较对照组明显降低(P<0.05)。观察组治疗后最大 P 波时限(Pmax)、最小 P 波时限(Pmin)及 PD 明显低于对照组(P<0.05)。观察组左心室射血分数(LVEF)明显高于对照组,左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)及 E/A 明显低于对照组(P<0.05)。两组患者治疗后 TNF-α、Hs-CRP 和 IL-6 水平均明显降低,观察组明显低于对照组(P<0.05)。观察组生活质量评分明显高于对照组(P<0.05)。

结论

美托洛尔可有效降低心脏起搏患者伴或不伴无症状心房颤动时心房颤动的发作频率、心房颤动负荷及炎症细胞因子水平,改善患者心功能及生活质量,具有重要的临床意义。

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