快速心律失常性心肌病射频消融术后环磷腺苷葡甲胺干预治疗的随机对照研究

目的：研究快速心律失常性心肌病射频消融术（RFCA）后环磷腺苷葡甲胺（商品名：心先安）干预治疗对心脏形态和功能恢复的影响。方法：采用随机单盲对照方法，将40例快速心律失常性心肌病患RFCA后分为治疗组和阳性对照组，两组分别静脉点滴心先安和灯盏花素注射液28d，然后比较两组临床表现，心胸比率，心脏实测与预测面积比值，心脏形态和功能，并进行统计学分析。结果：（1）治疗组和对照组总效率分别85％和15％，两组差异有显性（P＜0．01）。（2）心胸比率及心脏实测与预测面积的的比值显示，治疗组中扩大心室完全恢复正常占80％，而对照组完全恢复正常仅占10％（P＜0．01）。（3）二维彩色多普勒超声测量结果显示，心脏收缩及舒张功能指标在治疗组中有明显改善，而对照组变化不明显（P＜0．01）。结论：快速心律失常性心肌病引起的心脏扩大和心功能不全具有可逆性，心先安干预治疗可缩短病程5－10个月。

Meghumine cyclic adenylate treatment for tachycardicmyopathy after radiofrequency catheter ablation

Objective To study the changes in cardiomorphology and function in tachycardiomyopathy treated with meglumine cyclic adenylate (MCA) after radiofrequency catheter ablation (RFCA). Methods Forty patients with tachycardiomyopathy were divided into two groups. Twenty patients were given MCA intravenously for 28 days as the treatment group,and the other 20 patients were given breviscapin for 28 days as the positive control group. Changes in clinical manifestation, cardiac chest ratio,ratio of actual cardiac area to the estimated cardiac area and cardiac morphology and function on Doppler echocardiography in the two groups were analyzed with random single blind procedure comparative analysis. Results (1)Clinical curative effect: the total effective rate of the MCA group was 85%,while that of the breviscapin group was 15%.The difference was significant ( P < 0.01). (2) X ray examination indicated that the cardiac chest ratio and the actual cardiac area to estimated cardiac area ratio were changed dramatically in the treatment group,while those of the control group were changed slightly ( P <0.01). (3) Doppler echocardiography also displayed that all measurements of cardiac cavity and function parameters were improved greatly in the MCA group, while they were altered slightly in the control group ( P <0.01). Conclusion The cardiac dilatation and dysfunction in tachycardiomyopathy after RFCA are reversible,and can be shortened for 5-10 months with interventional treatment.