【摘要】 目的 探讨射频消融术治疗心力衰竭（HF）伴慢性心房颤动（AF）患者的临床效果。方法 选取2022年1月至2024年1月南昌市第一医院确诊收治的80例HF伴AF患者作为研究对象，采用随机数字表法分为药物组（n=40）和手术组（n=40）。药物组患者采用单纯药物治疗，手术组患者在药物组方法的基础上给予射频消融术治疗，两组均持续治疗3个月。比较两组患者的临床疗效与心功能指标[左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）]、血清指标[N末端B型利钠肽前体（NT-pro BNP）、肌酐（Cr）]水平；记录并比较两组患者术后6个月的心脏不良事件发生情况；随访12个月，记录并比较两组患者的AF复发情况。结果治疗3个月后，手术组的总有效率高于药物组，差异有统计学意义（P<0.05）。治疗前，两组的血清Cr、NT-pro BNP水平比较，差异无统计学意义（P>0.05）。治疗后，两组的血清Cr、NT-pro BNP水平均低于本组治疗前，且手术组的血清Cr、NT-pro BNP水平低于药物组，差异有统计学意义（P<0.05）。治疗前，两组患者的LVEF、LVEDD、LVESD比较，差异无统计学意义（P>0.05）。治疗后，两组患者的LVEF均高于本组治疗前，LVEDD、LVESD均低于本组治疗前；且手术组的LVEF高于药物组，LVEDD、LVESD均低于药物组，差异有统计学意义（P<0.05）。手术组术后6个月的心脏不良事件总发生率低于药物组，差异有统计学意义（P<0.05）。随访期间，手术组的AF总复发率低于药物组，差异有统计学意义（P<0.05）。结论 射频消融术能够有效改善HF伴慢性AF患者心功能，降低心脏不良事件风险，临床效果显著。更多还原

【Abstract】 Objective To explore the clinical effect of radiofrequency ablation in the treatment of patients with heart failure(HF) and chronic atrial fibrillation(AF). Methods A total of 80 patients with HF and AF who were diagnosed and treated in the First Hospital of Nanchang from January 2022 to January 2024 were selected as the research objects, and they were divided into drug group(n=40) and surgery group(n=40) by random number table method. The patients in the drug group were treated with drug alone, and the patients in the surgery group were treated with radiofrequency ablation on the basis of the drug group. Both groups were treated for 3 months. The clinical efficacy and cardiac function indexes(left ventricular ejection fraction [LVEF], left ventricular end-diastolic diameter [LVEDD], left ventricular end-systolic diameter [LVESD]),serum indexes(N-terminal pro-B-type natriuretic peptide [NT-pro BNP], creatinine [Cr]) were compared between the two groups. Cardiac adverse events were recorded and compared between the two groups at 6 months after surgery. After 12 months of follow-up, the recurrence of AF was recorded and compared between the two groups. Results After 3 months of treatment,the total effective rate of the surgery group was higher than that of the drug group, and the difference was statistically significant(P <0.05). Before treatment, there were no statistically significant differences in serum Cr and NT-pro BNP levels between the two groups(P >0.05).After treatment, the serum Cr and NT-pro BNP levels of the two groups were lower than those before treatment, and the serum Cr and NT-pro BNP levels of the surgery group were lower than those of the drug group, and the differences were statistically significant(P<0.05). Before treatment, there were no statistically significant differences in LVEF, LVEDD and LVESD between the two groups(P>0.05). After treatment, the LVEF of the two groups were higher than those before treatment, and the LVEDD and LVESD were lower than those before treatment, the LVEF of the surgery group was higher than that of the drug group, and the LVEDD and LVESD were lower than those of the drug group, and the differences were statistically significant(P<0.05). The total incidence of cardiac adverse events in the surgery group was lower than that in the drug group at 6 months after operation, and the difference was statistically significant(P<0.05). During the follow-up period, the total recurrence rate of AF in the surgery group was lower than that in the drug group, and the difference was statistically significant(P <0.05). Conclusion Radiofrequency ablation can effectively improve the cardiac function of patients with HF and chronic AF, reduce the risk of adverse cardiac events, and the clinical effect is significant.更多还原