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.
目的探讨二维相位对比(2D phase contrast,2D PC)磁共振成像(magnetic resonance imaging,MRI)序列在定量分析髂静脉压迫综合征(iliac vein compression syndrome,IVCS)患者静脉管腔内血液平均流速(mean blood flow velocity,MV)的应用价值。材料与方法前瞻性招募2023年12月到2024年7月在本院经数字减影血管造影(digital subtraction angiography,DSA)诊断明确为IVCS且需要血管腔内介入治疗的患者30例(试验组)及10名健康志愿者(对照组),收集患者临床资料并行1.5 T飞利浦超导MRI检查,在自由稳态进动(balance fast field echo,B-FFE)序列图像基础上分别在下腔静脉、双侧髂外静脉的冠状位、矢状位及轴位图上垂直扫描2D PC MRI序列,使用定量流量(quantitative flow,Q_FLOW)后处理软件得到血管垂直横切面感兴趣区(region of interest,ROI)内MV值。所有2D PC MRI检查进行两次,通过分析两次扫描结果的一致性(Bland-Altman图)来验证序列稳定性;分别比较IVCS试验组与对照组双侧髂外静脉MV值,评估IVCS患者髂总静脉受压对远端血流的影响;比较IVCS试验组(健侧髂外MV-患侧髂外MV)与对照组(右侧髂外MV-左侧髂外MV)髂外静脉MV差值,分析流速差诊断IVCS的效能;术中通过中心静脉导管(central venous catheter,CVC)测量IVCS患者组髂-下腔静脉压力梯度,并与患侧髂外静脉MV值进行相关性分析。结果两次2D PC MRI扫描结果一致性良好(P均血管腔内介入治疗的手术指征提供重要参考。
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