【摘要】 目的:探讨美托洛尔联合参松养心胶囊对阵发性心房颤动(PAF)患者的P波离散度(Pd)和血浆高敏C-反应蛋白(hs-CRP)的影响。方法:本研究共入选患者129例,其中PAF患者(PAF组)67例并随机分为3个亚组:美托洛尔组(A组,n=22)、参松养心胶囊组(B组,n=21)、美托洛尔和参松养心胶囊联合组(C组,n=24),62例窦性心律患者为对照组。比较PAF组和对照组治疗前后最大P波时限、Pd、血浆hs-CRP及左心房内径(LAD),疗程为3个月,观察PAF的复发率。结果:治疗前PAF组最大P波时限、Pd、血浆hs-CRP水平均高于对照组(P<0.05);A、B、C组治疗3个月后最大P波时限、Pd、血浆hs-CRP水平(不含A组)及PAF的复发率均降低,差异均有统计学意义(P<0.05～0.01);Pd≥40 ms比最大P波时限≥110 ms对预测PAF患者的敏感性和阴性预测值降低,但特异性和阳性预测值升高,最大P波时限≥110ms且P波离散度≥40 ms对预测PAF患者的特异度和阳性预测值均比单一指标高。结论:美托洛尔联合参松养心胶囊可以有效地降低PAF患者的最大P波时限、Pd、血浆hs-CRP水平和PAF的复发率。更多还原

【Abstract】 Objective:To explore the effect of metoprolol combined with shensongyangxin capsule on P wave dispersion(Pd) and high sensitivity C-reactive protein(hs-CRP) in patients with paroxysmal atrial fibrillation(PAF). Methods:A total of 129 patients were divided into two groups,Control group,n=62,the patients with sinus rhythm and PAF group,n=67,those patients were further divided into three subgroups as Metoprolol(M) group,n=22,Shensongyangxin capsule(S) group,n=21 and M+S group,n=24.The Maximum P wave duration(Pmax),Pd,plasma hs-CRP level and PAF recurrence rate were compared before and after 3 months treatment in different groups. Results:Before treatment,Pmax,Pd and plasma hs-CRP level in PAF group were higher than those in Control group P<0.05.After 3 months treatment,Pmax,Pd and PAF recurrence rate in M,S and M+S subgroups were decreased,P<0.01～0.05.For PAF patients,the sensitivity and negative predictive value of Pd≥40 ms was lower than that of Pmax=110 ms,while the specificity and positive predictive value was higher.The specificity and positive predictive value of Pmax=110 ms with Pd≥40 ms was higher than the single index. Conclusion:M+S treatment could effectively decrease Pmax,Pd in PAF patients and reduce PAF recurrence rate in clinical practice.更多还原