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胺碘酮联合磷酸肌酸钠治疗室性心律失常疗效及对血清NF-κB、CD40L水平的影响 预览

Efficacy of amiodarone combined with sodium creatine phosphate in the treatment of ventricular arrhythmia and its effect on serum NF-κB and CD40L levels
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摘要 目的观察胺碘酮联合磷酸肌酸钠治疗室性心律失常疗效及对血清NF-κB、CD40L水平的影响。方法 收集2015年1月—2017年12月辽宁省金秋医院心内四科收治室性心律失常患者90例作为研究对象,随机数字表法分为2组,每组45例。对照组患者给予胺碘酮治疗,观察组患者给予胺碘酮联合磷酸肌酸钠治疗。每个疗程7d,治疗2个疗程后,比较2组患者的治疗效果、肾上腺素受体自身抗体水平、校正QT离散度(QTc)和心率、血清炎性因子、血清NF-κB、CD40L、生命质量评分、不良反应等。结果观察组心律失常治疗总有效率高于对照组(86.67%vs.73.33%,χ^2=4.711,P=0.031);QTc高于对照组(t/P=3.023/0.003),心率低于对照组(t/P=3.546/0.001);抗β1、抗β2、抗α1抗体阳性病例明显低于对照组(χ^2/P=5.481/0.019、17.861/0.000、3.881/0.049);观察组血清TNF-α、IL-6、IL-8、NF-κB、CD40L水平均低于对照组(t/P=21.498/0.000、9.146/0.000、3.959/0.000、18.635/0.000、4.761/0.000);观察组生活质量和活动能力评分均高于对照组(t/P=7.275/0.000、10.346/0.000)。结论胺碘酮联合磷酸肌酸钠治疗室性心律失常能有效降低患者的血清炎性因子水平以及血清NF-κB、CD40L表达水平,下调肾上腺素抗体α1、β1及β2水平,提升患者的生活质量和活动能力,值得在临床进行推广。 Objective To observe the effect of amiodarone combined with sodium creatine phosphate on ventricular arrhythmia and the effects of serum NF-κB and CD40L levels.Methods From January 2015 to December 2017,90 patients with ventricular arrhythmia in the Department of Cardiology of Liaoning Province Jinqiu Hospital were enrolled as subjects.The random number table method was divided into 2 groups,45 cases in each group.Patients in the control group were treated with amiodarone,and patients in the observation group were treated with sodium creatine phosphate combined with amiodarone.After 7 days of treatment,after 2 courses of treatment,the therapeutic effects,adrenergic receptor autoantibody levels,corrected QT dispersion(QTc)and heart rate,serum inflammatory factors,serum NF-κB,CD40L,and life were compared between the two groups.Quality score,adverse reactions,etc.Results The total effective rate of arrhythmia treatment in the observation group was higher than that in the control group(86.67%vs.73.33%,χ^2=4.711,P=0.031);QTc was higher than the control group(t/P=3.023/0.003),and the heart rate was lower than the control group(t/P=3.546/0.001);anti-β1,anti-β2,anti-α1 antibody positive cases were significantly lower than the control group(χ^2/P=5.481/0.019,χ^2/P=17.861/0.000,χ^2/P=3.881/0.049);the serum levels of TNF-α,IL-6,IL-8,NF-κB and CD40L in the observation group were lower than those in the control group(t/P=21.498/0.000,t/P=9.146/0.000,t/P=3.959/0.000,t/P=18.635/0.000,t/P=4.761/0.000);the quality of life and activity scores of the observation group were higher than those of the control group(t/P=7.275/0.000,t/P=10.346/0.000).Conclusion Amiodarone combined with sodium creatine phosphate in the treatment of ventricular arrhythmia can effectively reduce serum inflammatory factor levels and serum NF-κB,CD40L expression levels,down-regulate the levels of adrenergic antibodiesα1,β1 andβ2.It is worth promoting in clinical practice to improve the quality of life and activity ability of patients.
作者 李延辉 陈瑶 黄莺 郝艳丽 LI Yanhui;CHEN Yao;HUANG Ying;HAO Yanli(Department of Cardiology,Liaoning Jinqiu Hospital ,Liaoyang 110016,China)
出处 《疑难病杂志》 CAS 2019年第4期334-338,共5页 Journal of Difficult and Complicated Cases
关键词 磷酸肌酸钠 胺碘酮 心律失常 室性 校正QT离散度 核转录因子κB 人可溶性CD40配体 Creatine phosphate sodium Amiodarone Arrhythmia,ventricular Corrected QT dispersion Nuclear factorκB Soluable CD40L
作者简介 通信作者:郝艳丽,E-mail:43607524@qq.com.
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