目的:应用心脏起搏器监测,比较决奈达隆与胺碘酮口服治疗阵发性心房颤动(后简称房颤)的临床疗效。方法:纳入安装心脏起搏器的阵发性房颤患者140例,分为决奈达隆组(观察组,70例)和胺碘酮组(对照组,70例)。比较两组药物治疗后起搏器记录的房颤事件频率、持续时间及相关并发症。结果:治疗前两组基线数据无显著差异。治疗3个月和1年后,房颤发生次数显著下降(P Objective: To utilize cardiac pacemaker monitoring to compare the clinical efficacy of oral dronedarone and amiodarone in the treatment of paroxysmal atrial fibrillation (AF). Methods: A total of 140 patients with paroxysmal AF who had cardiac pacemakers implanted were enrolled. The patients were divided into a dronedarone group (observation group, 70 cases) and an amiodarone group (control group, 70 cases). The frequency and duration of AF events recorded by pacemakers, as well as related complications, were compared between the two groups after treatment. Results: Baseline data showed no significant difference between the two groups before treatment. After 3 months and 1 year of treatment, the frequency of AF episodes significantly decreased (P < 0.05), with no statistically significant differences between the two groups. The incidence of complications was lower in the observation group, but the time to restore sinus rhythm after an AF episode was significantly longer compared to the control group (P < 0.05). Conclusion: In the maintenance therapy for AF, dronedarone and amiodarone exhibit comparable efficacy. Dronedarone is associated with fewer adverse effects and better patient compliance. However, amiodarone demonstrates superior performance in restoring sinus rhythm.
目的:本研究探讨MTHFR基因C677T多态性及同型半胱氨酸与高血压患者血压变异性之间的关系。方法:选取2023年1月至2024年10月期间,前往青岛大学附属医院心内科就诊的101例左心室射血分数正常的原发性高血压患者。采用24动态血压检测仪分别测量患者各血压指标[24 h收缩压(SBP)、24 h舒张压(DBP)、日间平均收缩压(dSBP)、日间平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)]、血压变异性指标[24 h收缩压变异系数(SBPV)、24 h舒张压变异系数(DBPV)、日间平均收缩压变异系数(dSBPV)、日间平均舒张压变异系数(dDBPV)、夜间平均收缩压变异系数(nSBPV)、夜间平均舒张压变异系数(nDBPV)]及特殊时间段血压指标(夜间血压下降率及清晨收缩压和舒张压)。于清晨空腹时抽取受试者静脉血样,通过全自动生化分析仪检测受试者的甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-c)、高密度脂蛋白(HDL-c)、转氨酶、血清肌酐(Cr)和血糖(空腹) (FBG)水平,并通过PCR荧光法检测MTHFR C677T基因型。根据不同基因型,将受试者分为CC (20例)、CT (58例)和TT (23例)组,以比较各组常规生化指标、同型半胱氨酸(Hcy)及动态血压指标差异。此外,对存在叶酸代谢障碍的TT型患者,按推荐剂量服用0.8 mg/天叶酸,连续6个月后再次测量其动态血压指标,以比较应用前后的变化。结果:共纳入符合标准的原发性高血压患者,各组年龄(64.95 ± 9.88 vs. 59.93 ± 11.85 vs. 59.87 ± 7.95, P = 0.175),性别比例(男:45% vs. 44.8% vs. 43.5%,P = 0.993),以及甘油三酯(TG)、胆固醇(TC)等一般资料均无统计学意义(P > 0.05)。然而,与Hcy水平存在显著差异(8.09 (7.66~8.52) vs. 13.00 (11.40~13.90) vs. 21.20 (19.00~22.30), P Objective: This study aimed to explore the relationship between MTHFR gene C677T polymorphism, homocysteine, and blood pressure variability in patients with hypertension. Methods: A total of 101 patients with primary hypertension and normal left ventricular ejection fraction who visited the Department of Cardiology of the Affiliated Hospital of Qingdao University from January 2023 to October 2024 were selected. Blood pressure indicators [24-hour systolic blood pressure (SBP), 24-hour diastolic blood pressure (DBP), daytime average systolic blood pressure (dSBP), daytime average diastolic blood pressure (dDBP), nighttime average systolic blood pressure (nSBP), and nighttime average diastolic blood pressure (nDBP)], blood pressure variability indicators [24-hour systolic blood pressure variability coefficient (SBPV), 24-hour diastolic blood pressure variability coefficient (DBPV), daytime average systolic blood pressure variability coefficient (dSBPV), daytime average diastolic blood pressure variability coefficient (dDBPV), nighttime average systolic blood pressure variability coefficient (nSBP
目的:炎症反应参与ASCVD及CKD的发生发展,而PCSK9抑制剂在抑制炎症方面有较好的作用,文章旨在探究应用PCSK9抑制剂后ASCVD合并CKD患者炎症指标的变化情况及心血管不良事件的发生情况以及SII对于MACEs的预测价值。方法:文章纳入青岛大学附属医院心血管内科就诊的患者共90例,随机分为两组,A组应用他汀 + PCSK9抑制剂治疗,B组应用他汀 + 依折麦布治疗,随访研究对象用药后炎症指标变化及心血管事件发生情况。结果:治疗后3个月,A组淋巴细胞较B组明显升高,SII、NLR、PLR较B组有明显下降;治疗后6个月,除上述指标改善外,A组中性粒细胞、单核细胞较B组有明显下降,差异具有统计学意义(P Objective: Inflammatory response to the development of ASCVD and CKD, PCSK9 inhibitors have a better role in inhibiting inflammation. The purpose of this paper is to explore the changes in inflammatory indicators and the occurrence of adverse cardiovascular events in patients with ASCVD combined with CKD after the application of PCSK9 inhibitors and the predictive value of SII for MACEs. Methods: A total of 90 patients attending the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University were included in this article. Randomly divided into two groups, Group A was treated with statin + PCSK9 inhibitor, and Group B was treated with statin + ezetimibe. Follow-up of study subjects for post-drug inflammatory markers and cardiovascular events during follow-up. Results: At 3 months after treatment, lymphocytes in Group A were significantly higher than those in Group B, and SII, NLR, and PLR were significantly lower than those in Group B. At 6 months after treatment, in addition to the improvement of the above indexes, neutrophils and monocytes in group A were significantly lower than those in group B, and the difference was statistically significant (P < 0.05). By the end of follow-up, the incidence of MACEs events was less in Group A than in Group B. SII was an influential factor in the occurrence of MACEs in patients;SII, NLR, and PLR had good sensitivity and specificity in predicting the occurrence of MACEs events in patients with ultra-high-risk ASCVD combined with CKD. Conclusion: After the application of PCSK9 inhibitors, the patients’ inflammatory indexes and the risk of developing MACEs decreased compared with the control group. SII
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