目的 探讨曲美他嗪和美托洛尔对心脏起搏患者心房颤动及无症状性心房颤动的影响.方法 2013年8月到2016年2月选择在我院植入双腔永久心脏起搏器术后出现心房颤动的患者86例作为研究对象,根据随机信封抽签原则分为观察组与对照组各43例.对照组起搏器植入术后3个月开始口服美托洛尔治疗,观察组在对照组治疗基础上加用曲美他嗪治疗,两组治疗观察时间为3个月.结果 所有患者都完成治疗,治疗期间无血栓、心力衰竭、出血及死亡事件发生.观察组治疗后6例发生心房颤动,其中无症状性心房颤动4例;对照组治疗后14例发生心房颤动,其中无症状性心房颤动3例,观察组明显好于对照组(P<0.05).治疗后观察组与对照组的血清CRP和IL-6水平分别为(2.19±0.49)mg/L、(87.39±51.43)pg/ml和(4.22±0.99)mg/L、(103.88±41.45)pg/ml,都明显低于治疗前(P<0.05),同时治疗后观察组的血清CRP与IL-6水平也明显低于对照组(P<0.05).观察组治疗后的LAEDD与IVST值分别为(40.67±2.14)mm和(12.11±0.98)mm,而对照组分别为(43.29±1.40)mm和(13.78±0.91)mm,观察组明显低于对照组(P<0.05),且都明显低于治疗前(P<0.05).结论 心脏起搏患者应用曲美他嗪联合美托洛尔可抑制心房颤动及无症状性心房颤动的发生,显著改善患者的心房重构,其作用机制可能与抗炎有关.%Objective To investigate the intervening effects of Trimetazidine combined with Metoprolol in the treatment of cardiac pacing patients with atrial fibrillation and without asymptomatic atrial fibrillation. Meth-ods From August 2013 to February 2016, 88 atrial fibrillation patients with implanted dual chamber permanent cardiac pacemaker in our hospital were selected as the research object, all the patients were randomly divided into observation group and control group of 43 patients accorded to the random lottery envelopes. The control group was given Metoprolol therapy after pacemaker implantation for 3 months, the observation group was added given the Trimetazidine therapy based on the control group. Two groups were observed for 3 months. Results All patients were completed the treatment and there were no thrombosis, heart failure, bleeding and death occurred during the treatment. After treatment, there were 6 patients were atrial fibrillation occurred the observation group that included 4 patients of without asymptomatic atrial fibrillation; while the control group were 14 patients of atrial fibrillation that included 3 patients of without asymptomatic atrial fibrillation, the observation group was better in the control group (P<0.05). After treatment, the levels of serum CRP and IL-6 in observation group and control group were (2.19±0.49)mg/L,(87.39±51.43)pg/ml and(4.22±0.99)mg/L,(103.88±41.45)pg/ml that were significantly less than those before treatment (P<0.05), while the serum CRP and IL-6 levels in the observation group after treat-ment were significantly less than those in the control group (P<0.05). The LAEDD and IVST values in the obser-vation group after treatment were(40.67±2.14)mm and(12.11±0.98)mm, while the control group were(43.29± 1.40)mm and (13.78±0.91)mm, the observation group were significantly lower than the control group (P<0.05) and were significantly lower than those before treatment (P<0.05). Conclusion The application of Trimetazidine combined with Metoprolol in the treatment of cardiac pacing patients with atrial fibrillation and without asymptomat-ic atrial fibrillation can inhibit the occurrence of atrial fibrillation, it has significant improvement for atrial remodel-ing, the mechanism may be related to anti inflammation.
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