| 摘要: |
| 目的 观察降糖措施对阵发性房颤伴高血糖患者电复律的影响及电复律效果的影响因素。 方法 选取106例阵发性房颤伴高血糖患者进行前瞻性研究,按随机数表法分为观察组与对照组,各53例。对照组采取同步直流电复律治疗,观察组在对照组基础上应用格列吡嗪进行降糖。比较两组电复律1次成功率与总成功率、治疗前和治疗后3 d的一氧化氮(NO)浓度与血浆血管假性血友病因子(vWF)水平。将患者按电复律结果分为成功组(96例)与失败组(10例),比较两组性别、年龄、电复律前即刻血糖水平、心室率、左方内径、合并高血压、房颤持续时间,并进行多因素Logistic回归分析明确电复律成功的影响因素。结果 观察组电复律1次成功率与总成功率分别为81.13%与96.23%,显著高于对照组62.26%与84.91%(P＜0.05)。两组治疗前的血清NO与vWF水平无统计学意义(P＞0.05)；治疗后3 d观察组血清NO水平均显著升高、血清vWF水平大幅降低(P＜0.05)。观察组治疗后3 d的血清NO水平为(48.39±12.40)μmol/L显著高于对照组(32.10±7.22)μmol/L,血清vWF水平为(111.89±26.31)%,显著低于对照组(141.07±24.26)%(P＜0.05)。电复律前即刻血糖水平、左房内径、房颤持续时间均为电复律成功率的影响因素(P＜0.05)。结论 血糖水平对电复律成功率有一定影响,阵发性房颤伴高血糖患者采取降糖治疗可提高电复律成功率,同时应警惕糖尿病存在的可能。电复律效果的影响因素包括电复律前即刻血糖水平、左房内径、房颤持续时间。 |
| 关键词: 阵发性房颤 高血糖 降糖治疗 电复律 |
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| Analysis of factors influencing the effect of cardioversion in patients with paroxysmal atrial fibrillation and hyperglycemia |
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| Abstract: |
| Objective To observe the effect of hypoglycemic measures on the electric cardioversion of patients with paroxysmal atrial fibrillation and hyperglycemia, and to explore the influencing factors of the effect of electrical cardioversion. Methods 106 patients with paroxysmal atrial fibrillation and hyperglycemia were prospectively studied. According to the random number table, the patients were divided into observation group and control group, with 53 cases in each group. The control group was treated by synchronous DC cardioversion. The observation group was treated with glipizide for hypoglycemic treatment on the basis of the control group. The success rate and total success rate of primary cardioversion were compared between the two groups. The levels of nitric oxide (NO) and plasma von Willebrand factor (vWF) before and 3 days after treatment were compared. The patients were divided into two groups according to the results of electrocardiogram: successful group (96 cases) and failure group (10 cases). The gender, age, immediate blood glucose levels before cardioversion, ventricular rate, left internal diameter, combined hypertension, duration of atrial fibrillation Multivariate logistic regression analysis to determine the impact of electrical cardioversion success factors. Results The success rate and total success rate of primary cardioversion in observation group were 81.13% and 96.23%, which were significantly higher than 62.26% and 84.91% in control group (P < 0.05). Before treatment, serum NO and vWF levels were not statistically significant (P > 0.05). After 3 days of treatment, serum NO levels in the observation group were significantly increased, serum vWF levels were significantly reduced (P < 0.05). The NO level at 3 d after treatment in the observation group was (48.39±12.40) μmol/L, which was significantly higher than (32.10±7.22) μmol/L in the control group(P <0.05). The serum level of vWF was (111.89±26.31)% at 3 d after treatment in the observation group, whcih was significantly lower than (141.07±24.26)% in the control group(P <0.05). The immediate blood glucose levels before cardioversion, left atrial diameter, duration of atrial fibrillation were the influencing factors of the success rate of electrocardiogram (P < 0.05). Conclusion The blood glucose level has a certain impact on the success rate of electrical cardioversion. Patients with paroxysmal atrial fibrillation and hyperglycemia should be treated with hypoglycemic therapy to improve the success rate of electrical cardioversion. At the same time, the possibility of diabetes mellitus should be observed. Factors that affect the effect of cardioversion include immediate blood glucose levels, left atrium diameter, and duration of atrial fibrillation before cardioversion. |
| Key words: Paroxysmal atrial fibrillation Hyperglycemia Hypoglycemic therapy Cardioversion |