疏血通治疗慢性肺心病并发阵发性房颤的效果和 安全性观察

目的 探讨疏血通注射液治疗慢性肺源性心脏病（肺心病）并发阵发性房颤的临床疗效及安全性。方法 将 91 例慢性肺心病并发阵发性房颤患者随机分为治疗组 45 例和对照组 46 例， 对照组在常规治疗（吸氧、 祛痰、 平喘） 的基础上给予氯吡格雷 75 mg 口服， 治疗组在对照组基础上加用生理盐水 250 mL+疏血通 6 mL 静脉滴注，均 1 次/d， 应用 14 d。检测 48 h 内阵发性房颤转复为窦性心律的时间； 用药 48 h 及 14 d 时阵发性房颤转复窦性心律维持例数； 于治疗前及治疗 14 d 时采用胶体金法检测 D-二聚体（D-Dimer）， 并监测肝、 肾功能及药物不良反应。结果 治疗组在 48 h 内阵发性房颤转复为窦性心律的时间与对照组差异无统计学意义（h： 12.62±2.32 vs 13.32± 2.25， t=1.461）； 治疗组用药 48 h 及 14 d 时阵发性房颤转复窦性心律维持率分别是 86.67%（39/45）、 82.22%（37/45），均高于对照组的 69.56%（32/46）、 60.87%（28/46）。治疗 14 d 时， 治疗组 D-Dimer(2.05±0.34)mg/L]较治疗前(2.61± 0.27)mg/L]降低， 且低于对照组(2.53±0.31)mg/L] （均 P＜0.05）。2 组治疗期间均未出现肝、 肾功能异常， 且均未发生不良反应。结论 疏血通注射液联合氯吡格雷口服可防治慢性肺心病患者阵发性房颤的复发， 降低血栓栓塞的风险， 安全有效。

The safety and efficacy of Shuxuetong in treatment of paroxysmal atrial fibrillation in patients with chronic pulmonary heart disease

Objective To observe the clinical efficacy and safety of Shuxuetong in treatment of paroxysmal atrial fibrillation in patients with chronic pulmonary heart disease. Methods A randomized single-blinded study was performed. A total of 91 patients with paroxysmal atrial fibrillation and chronic pulmonary heart disease were randomly divided into treatment group (n=45) and control group (n=46). The treatment group was received Shuxuetong and clopidogrel treatment for 14 days. The control group was given routine treatment plus clopidogrel 75 mg orally. The average time of cardioversion of paroxysmal atrial fibrillation was detected within 48 hours. The cardioversion rate of paroxysmal atrial fibrillation and the total efficiency were detected after14 days. The serum D-Dimer was detected before and 14 days after treatment . Liver and kidney function and adverse drug reactions were also detected. Results There was no significant difference in average time of cardioversion of paroxysmal atrial fibrillation in 48 h between two groups (h： 12.62±2.32 vs 13.32±2.25， t=1.461). The cardioversion rates were 86.67%(39/45) and 82.22%(37/45) at 48 h and 14 d in treatment group, which were significantly higher than those of control group 69.56%(32/46) and 60.87(28/46)]. The D-Dimer at 14 d after treatment was significantly lower in treatment group (2.05±0.34)mg/L] than before treatment(2.61±0.27)mg/L], also than that of control group(2.53±0.31)mg/L]. There were no abnormal liver and kidney function and no adverse reactions between two groups. Conclusion Shuxuetong can significantly prevent the recurrence of paroxysmal atrial fibrillation in patients with chronic pulmonary heart disease, and help to reduce the risk of thromboembolism. It is safe and effective.