Objective To investigate whether dexamethasone can increase the success rate of drug conversion in patients with persistent atrial fibrillation (AF) and to explore its mechanism. Methods A total of 82 patients with persistent atrial fibrillation who were admitted to the department of emergency of the Central Hospital of Handan from January 1, 2014 to December 30, 2016 were randomly divided into the control group according to the random number table (41 cases). And the observation group (41 cases), the observation group was given 3 weeks of warfarin and 3 days of dexamethasone before the drug cardioversion, the control group was given 3 weeks of warfarin and 3 days of placebo before the drug cardioversion, and the patients after the drug failure failed Electroacupuncture treatment was performed to compare the effective rate of drug conversion, the time of conversion, the changes of cardiac structural indexes indicated by cardiac ultrasound and the levels of serum inflammatory index C-reactive protein (CRP) and procalcitonin (PCT). Results The atrial fibrillation drug conversion success rate observation group (36.58%) was statistically different from the control group (17.07%) (P<0.05). The heart rate of both groups was decreased after cardioversion and before the cardioversion. The difference was statistically significant (P<0.01). However, there was no significant difference in heart rate between the two groups after cardioversion (P>0.05). The left ventricular posterior wall thickness of the observation group was thinner than that of the control group after cardioversion (P<0.05). The systolic blood pressure of the observation group was lower than that before the cardioversion (P<0.05). There were no significant differences in left atrial diameter, left ventricular ejection fraction, and diastolic compression ratio (P>0.05). The CRP and PCT levels in the observation group were significantly lower than those in the control group at 1 day, 2 days, and 3 days after treatment. The difference was statistically significant (P<0.05). Conclusions Dexamethasone can enhance the ability of drug cardioversion atrial fibrillation by decreases inflammation.%目的 研究地塞米松是否可以增加持续性心房颤动(房颤)患者药物转复的成功率,并初步探讨其机制.方法 入选2014年1月1日至2016年12月30日就诊于邯郸市中心医院急诊科的持续性房颤患者,共82例持续性房颤患者,依据随机数字表随机分为对照组(41例)和观察组(41例),观察组药物复律前给予3周华法林和3 d地塞米松治疗,对照组药物复律前给予3周华法林和3 d安慰剂治疗,药物转复失败后的患者接受电转复治疗,比较两组患者药物转复有效率、转复时间、转复后心脏超声所示心脏结构指标变化及血清炎症指标C反应蛋白(CRP)及降钙素原(PCT)水平.结果 心房颤动药物转复成功率观察组(36.58%)与对照组(17.07%)相比,有统计学性差异(P＜0.05);两组患者复律后与复律前比较,心率均下降,差异有统计学意义(P＜0.01);但两组患者复律后心率比较,无统计学差异(P＞0.05);观察组患者复律后左室后壁厚度较对照组患者薄(P＜0.05);观察组患者复律后收缩压较复律前降低(P＜0.05).左房内径、左室射血分数、舒张压复率前后,差异均无统计学意义(P均＞0.05).观察组患者用药后1 d,2 d,3 d CRP与PCT水平同对照组比较,均明显降低,差异均有统计学意义(P＜0.05).结论 地塞米松可能通过减轻炎症反应提高药物转复的成功率.
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