| 苏 哲,郑 霄,吕向妮,张海燕,张 平.瓣膜手术同期射频消融改良迷宫术治疗心脏瓣膜病并发房颤患者的疗效及对血清细胞因子的影响[J].,2019,19(24):4678-4681 |
| 瓣膜手术同期射频消融改良迷宫术治疗心脏瓣膜病并发房颤患者的疗效及对血清细胞因子的影响 |
| Efficacy of Radiofrequency Ablation Combined with Modified Maze In the Treatment of Patients with Atrial Fibrillation Caused by Valvular Disease and Its Effect on the Serum Cytokines |
| 投稿时间：2019-06-06 修订日期：2019-06-30 |
| DOI：10.13241/j.cnki.pmb.2019.24.017 |
| 中文关键词: 心脏瓣膜病 房颤 瓣膜手术 射频消融改良迷宫术 细胞因子 |
| 英文关键词: Valvular heart disease Atrial fibrillation Valve surgery Radiofrequency ablation modified maze procedure Cytokines |
| 基金项目:陕西省自然科学基金项目(2014S260) |
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| 中文摘要: |
| 摘要 目的：分析瓣膜手术同期射频消融改良迷宫术治疗心脏瓣膜病并发房颤患者的疗效及对血清细胞因子的影响。方法：将80例心脏瓣膜病并发房颤患者依据简单随机法分为对照组和观察组，每组40例。对照组采用心脏瓣膜置换术治疗，观察组采用心脏瓣膜置换术同期射频消融改良迷宫术治疗，比较两组窦性心律转复情况，手术情况，手术前后心功能、血清金属蛋白酶组织抑制因子-1(TIMP-1)、基质金属蛋白酶-1(MMP-1)和基质金属蛋白酶-9(MMP-9)水平的变化以及术后并发症的发生情况。结果：观察组术后当天、术后1月、术后3月及术后6月的窦性心律转复率均显著高于对照组(P<0.05)，体外循环时间、主动脉阻断时间及术后24 h引流量均明显多于对照组(P<0.05)。两组呼吸机使用时间和监护室时间比较差异无统计学意义(P>0.05)。术后6个月，两组左室舒张末期内径、左室收缩末期内径、血清MMP-1和MMP-9水平均较术前显著下降，且观察组以上指标明显低于对照组；两组LVEF及血清TIMP-1水平较术前显著上升，且观察组以上指标均显著高于对照组(P<0.05)。两组术后均无严重并发症发生。结论：瓣膜手术同期射频消融改良迷宫术治疗心脏瓣膜病并发房颤安全有效，早期窦性心律的转复率高，且可改善患者血清TIMP-1、MMP-1、MMP-9水平。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the efficacy of radiofrequency ablation combined with modified maze in the treatment of patients with atrial fibrillation caused by valvular disease and its effect on the serum cytokines. Methods: 80 patients with valvular heart disease complicated with atrial fibrillation were divided into control group and observation group according to simple random method, 40 cases in each group, the control group was treated with cardiac valve replacement, while the observation group was treated with valve surgery concomitant radiofrequency ablation modified maze. The sinus rhythm reversion, operation conditions, changes of cardiac function, levels of metalloproteinase -1(TIMP-1), matrix metalloproteinase -1(MMP-1) and matrix metalloproteinase -9(MMP-9) before and after operation, and occurrence of postoperative complications were compared between the two groups. Results: The sinus rhythm conversion rates of observation group on the day after operation, at 1, 3, 6 month after operation were significant higher than those of the control group (P<0.05). The extracorporeal circulation time, aortic occlusion time and postoperative 24 h drainage volume were significantly higher than those in the control group (P<0.05). there was no significant difference between the two groups in the ventilator usage time and intensive care unit time (P>0.05). At six months after operation, the left ventricular end diastolic diameter, left ventricular end systolic diameter, serum levels of MMP-1 and MMP-9 in both groups were significantly lower than those before operation, and the above indexes in the observation group were significantly lower than those in the control group. The levels of LVEF and TIMP-1 in serum of the two groups were significantly higher than those before operation, which were higher in the observation group than that of the control group (P<0.05). No severe complication occurred in both groups. Conclusion: Valve surgery concomitant radiofrequency ablation modified maze is safe and effective in the treatment of atrial fibrillation complicated by valvular heart disease, has high conversion rate of early sinus rhythm, and can improve the serum levels of TIMP-1, MMP-1 and MMP-9. |
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