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阿托伐他汀对伴有高血压病的病态窦房结综合征患者双腔起搏疗效的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第6期
页码:
676-679
栏目:
临床研究
出版日期:
2014-06-25

文章信息/Info

Title:
Effects of atorvastatin application on atrial high rate episodes in dual-chamber paced patients with hypertension
作者:
魏子秀1; 孙 辉1; 张 梅2; 孙晓斐1
(1.济宁市第一人民医院心脏中心，山东 济宁 272111；
2.山东大学齐鲁医院心内科，山东 济南 250012)
Author(s):
WEI Zi-xiu1;  SUN Hui1;  ZHANG Mei2;  SUN Xiao-fei1
(1.Center of Cardiology, Jining First People’s Hospital, Jining, Shandong 272111, China;
2.Department of Cardiology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China)
关键词:
病态窦房结综合征; 高血压; 原发性; 双腔起搏; 阿托伐他汀; 超敏C反应蛋白
Keywords:
sick sinus syndrome;  hypertension;  dual-chamber pacing;  atorvastatin;  C-reactive protein
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的:观察阿托伐他汀对并发高血压病的病态窦房结综合征（SSS）患者双腔起搏的疗效［心房高频事件（AHREs）和炎症］的影响。方法： 选择49例并发高血压病的SSS行双腔起搏器植入的患者，随机分为对照组和试药组随访观察12个月，对照组(n=25)给予常规治疗，试药组（n=24）在常规治疗基础上加阿托伐他汀20 mg/d至研究结束。研究开始及结束时测所有患者血浆超敏C反应蛋白（hs-CRP）及血脂水平。研究开始及结束时分别进行随访，调出起搏器存储仪记录数据，统计AHREs发作次数(次/年，超过5 min者进入统计)、AHREs持续时间(h/年)、以及心房起搏百分比［(AP(%)］、心室起搏百分比［VP(%)］等数据，应用SPSS 16.0统计软件进行分析。结果： 研究结束后试药组AHREs次数、AHREs负荷均较对照组显著降低(P<0.05)。而两组间AP(%)与VP(%)较用药前相比以及用药前后组间相比差异均未达到统计学意义。研究结束后试药组血浆hs-CRP水平显著低于对照组(P<0.05)，血脂改善(P<0.05)。研究期间AHREs发作次数（次/年）、AHREs持续时间均与hs-CRP呈正相关。结论： 阿托伐他汀对并发高血压病且行双腔起搏器植入的SSS患者有降低AHREs负荷的作用，其机制可能与阿托伐他汀抑制炎症反应及调脂有关。
Abstract:
AIM:To determine the effectiveness of atorvastatin treatment on reducing the occurrence of atrial high rate episodes (AHREs) recorded by pacemakers in sick sinus syndrome (SSS) patients with hypertension after dual-chamber pacemaker implantation. METHODS: Forty nine SSS patients with hypertension and accepted treatment of dual-chamber pacemaker implantation were enrolled in this study and were divided into treatment and control groups for a 12-month follow-up. Patients in the control group (n=25) were treated with standard therapy practices after dual-chamber pacemaker implantation, whereas patients in the treatment group (n=24) were prescribed atorvastatin at a dosage of 20 mg/day combined with standard therapy practices until the end of the study. C-reactive protein and serum lipid levels were examined at baseline and after follow-up. During the visits, the pacemaker memories were recorded. The frequency of AHREs (times/year, those that were longer than 5 min were recorded), duration of the AHREs (h/year), percentage of atrial pacemaking ［AP(%)］ and percentage of ventricular pacemaking ［VP(%)］ were recorded. SPSS v.16.0 software package was used for statistical analysis. RESULTS: 1. Times and duration of AHREs in the treatment group were significantly lower than what was observed in the control group (P<0.05). Comparisons of AP(%) and VP(%) between groups did not show significant differences. 2. At the end of follow-up, hs-CRP levels in the treatment group showed a marked decrease compared to those in the control group (P<0.05). 3. hs-CRP level during follow-up, respectively, correlated well with AHREs times and AHREs duration. 4. Serum lipid profile in the treatment group was ameliorated at the end of treatment (P<0.05) compared with that in the control group. CONCLUSION: Atorvastatin can decrease the frequency and duration of AHREs after dual-chamber pacemaker implantation. It is possible that the mechanism may have a relationship with the anti-inflammatory actions and ameliorating serum lipid of statins.

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备注/Memo

备注/Memo:
收稿日期：2014-01-22.
作者简介：魏子秀，副主任医师，博士Email：wzix@sina.com
更新日期/Last Update: 2014-07-10