美托洛尔和曲美他嗪治疗阵发性心房颤动及对血清心型脂肪酸结合蛋白的影响

目的 观察联合美托洛尔缓释片和曲美他嗪治疗心房颤动（房颤）的临床疗效及对血清心型脂肪酸结合蛋白（heart fatty acid-binding protein,H-FABP）的影响.方法 按既定标准入选阵发性房颤患者共160例,分为治疗组和对照组各80例.对照组为美托洛尔缓释片组,治疗组在对照组治疗基础上加用曲美他嗪.对比治疗前和治疗后随访10个月心电图及24h动态心电图（Holter）、左心房内径及两组治疗前、后血清H-FABP浓度的变化.结果 两组治疗后心率、24 h房性期前收缩及房性心动过速的发作次数较治疗前改善,差异有统计学意义（P＜0.05）.治疗后治疗组临床疗效（包括房颤发作入院次数、房性期前收缩、房性心动过速的发作次数）优于对照组,差异有统计学意义（P＜0.05）.随访10个月后,治疗组左心房内径明显小于对照组,差异有统计学意义[（39.39±4.12） mm vs.（41.46±3.52） mm,P＜0.05].治疗组血清H-FABP浓度低于治疗前,差异有统计学意义[（2.2±1.4）ng·mL-1vs.（2.9± 1.6）ng·mL-1,P＜0.05].结论 联合美托洛尔缓释片和曲美他嗪治疗阵发性房颤,能显著降低其血清H-FABP浓度,同时可改善心房重构,减少房颤的复发.

Efficacy of metoprolol in combination with trimetazidine in patients with atrial fibrillation and its effects on serum concentrations of H-FABP

Objectives To study the efficacy of trimetazidine in combination with metoprolol sustained release tablets in patients with atrial fibrillation and the effects on serum concentrations of heart fatty acid-binding protein （H-FABP）. Methods A total of 160 patients with atrial fibrillation were randomly divided into two groups. For routine treatment group （n=80）, patients were treated with metoprolol sustained release tablets; for trimetazidine treatment group （n=80）, patients were treated with trimetazidine on the basis of routine treatment. All the patients were followed up for 10 months. The changes of clinical symptoms and serum concentrations of H-FABP were compared. Results After treatment, clinical symptoms of both groups significantly improved （P〈0.05）. Clinical symptoms of trimetazidine treatment group were significantly improved than routine treatment group （P〈0.05）. Left atrial diameter （LAD） of trimetazidine treatment group was significantly smaller than that of routine treatment group after 10 months [ （39.39±4.12） mm vs. （41.46±3.52） mm, P〈0±.05 ]. Serum concentrations of H-FABP of trimetazidine treatment group significantly decreased after treatment [ （2.2±1.4） ng.mL-1 vs. （2.9±1.6） ng.mL-1, P〈0.05]. Conclusions Trimetazidine in combination with metoprolol sustained release tablets can prevent recurrence of paroxysmal artial fibrillation, decrease serum concentrations of H-FABP and inhibit left atrial structural remodeling.