2017 年第 10 期 第 12 卷

射频导管消融术对阵发性心房颤动患者长期生活质量的影响

Effect of radiofrequency catheter ablation on long-term quality of life in patients with paroxysmal atrial fibrillation

作者：晁鹏王勇任澎

英文作者：Chao Peng Wang Yong Ren Peng

单位：830001乌鲁木齐，新疆维吾尔自治区人民医院心内科

英文单位：Department of Cardiology People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830001 China

关键词：心房颤动；导管消融术；生活质量

英文关键词：Atrialfibrillation；Catheterablation；Qualityoflife

• 摘要：

• 目的 探讨射频导管消融术（RFCA）对阵发性心房颤动患者长期生活质量的影响。方法 选取2008年6月至2010年6月就诊于新疆维吾尔自治区人民医院的阵发性心房颤动患者204例，根据患者自行要求的治疗方法不同分为药物治疗组（105例）与RFCA治疗组（99例）。所有患者在治疗前和治疗后2、5年门诊随访，进行12导联心电图、连续7 d动态心电图检查以及健康状况调查量表（SF-36）评分，比较2组治疗前和治疗后2、5年随访时心房颤动发生情况和生活质量。结果 治疗后2、5年随访时，RFCA治疗组和药物治疗组心房颤动复发率均明显小于治疗前［RFCA治疗组：10.3%(9/87)、8.1%（6/74）比100.0%（99/99）；药物治疗组：21.7%（18/83）、20.8%（15/72）比100.0%（105/105）］，且RFCA治疗组心房颤动复发率均明显小于药物治疗组（均P＜0.01）。治疗后2年随访，药物治疗组情绪对角色功能的影响（RE）评分及RFCA治疗组SF-36总分和躯体功能对角色功能的影响（RP）、躯体活动功能（PF）、躯体疼痛、RE评分均明显高于治疗前［（76±11）分比（69±9）分、（572±110）分比（546±112）分、（63±10）分比（55±17）分、（80±14）分比（71±15）分、（74±11）分比（66±11）分、（84±10）分比（75±15）分］（均P＜0.01），2组间无论是SF-36总分还是各维度评分比较，差异均无统计学意义（均P＞0.05）。治疗后5年随访，2组SF-36总分和RP、PF、躯体疼痛、RE评分均明显高于治疗前（均P＜0.01），且2组间比较差异有统计学意义（均P＜0.01）。结论 RFCA可作为阵发性心房颤动患者的首选治疗方法，其在复发率及生活质量方面均优于药物治疗。

• Objective To investigate the effect of radiofrequency catheter ablation（RFCA） on long-term quality of life in patients with paroxysmal atrial fibrillation. Methods Totally 204 patients with paroxysmal atrial fibrillation were enrolled from June 2008 to June 2010 in People′s Hospital of Xinjiang Uygur Autonomous Region; 105 patients had drug treatment（drug group） and 99 patients had RFCA treatment（RFCA group）. All of the patients had 12-lead electrocardiogram and 7 d dynamic electrocardiogram examination before and 2, 5 years after treatment. The score of 36-item Short Form Health Survey（SF-36） was used to evaluate quality of life. The recurrence of atrial fibrillation was observed. Results The recurrence rates of atrial fibrillation in RFCA group and drug group during 2 and 5 years of follow-up were significantly lower than those before treatment［RFCA group： 10.3%（9/87）， 8.1%（6/74） vs 100.0%（99/99）； drug group： 21.7%（18/83）, 20.8%（15/72） vs 100.0%（105/105）］（P＜0.01）; the 2,5-year recurrence rates of atrial fibrillation in RFCA group were significantly lower than those in drug group（P＜0.01）. Two years after treatment, the score of role-emotional in drug group and the total score of SF-36, scores of role-physical, physical functioning, bodily pain and role-emotional in RFCA group were significantly higher than those before treatment［（76±11）scores vs （69±9）scores, （572±110）scores vs （546±112）scores, （63±10）scores vs （55±17）scores, （80±14）scores vs （71±15）scores, （74±11）scores vs （66±11）scores, （84±10）scores vs （75±15）scores］（P＜0.01）; there were no significant differences of the total score of SF-36 and scores of items between groups（P＞0.05）. Five years after treatment, the total score of SF-36, scores of role-physical, physical functioning, bodily pain and role-emotional were significantly higher than those before treatment in both groups and there were significant differences between groups（P＜0.01）. Conclusions RFCA has better effects on atrial fibrillation recurrence and quality of life than drug treatment; it may be the first choice for treatment of paroxysmal atrial fibrillation.