聚焦心房颤动基础研究和上游防治中亮点.docVIP

聚焦心房颤动基础研究和上游防治中亮点 　　[摘要]我国有心房颤动（AF）患者800万～1000万例，由AF引起的卒中为24.8%，是广大医务工作者任重而道远的光荣使命。近年来在AF的基础和临床研究都取得可喜成绩，出现不少新亮点。诸如在左上肺静脉入口等处发现有袖套细胞，导管左心耳封堵术或结扎术可治疗大部分阵发性AF患者；临床上加强HBP管理、减肥、服用ACEI、ARB、他汀等可预防发生AF；在器械复律、射频消融、药物复律等AF患者抗栓治疗上都有新的进展。 　　[关键词]心房颤动；重构；心率/心律；胺碘酮；抗栓 　　[中图分类号] R541.75 [文献标识码] B [文章编号] 2095-0616（2014）24-137-03 　　The bright spot about focusing on atrial fibrillation in the basic research and prevention of the upstream 　　XIAO Guihong1 CHEN Shaoxia2 ZHOU Daoqi2 ZHANG Aipeng2 LI Bing2 　　1.Internal Medicine of Rehabilitation Hospital in Xuzhou City in Jiangsu Province， Xuzhou 221003， China； 2.Internal Medicine Teaching and Research Section of Shantou Dafeng Hospital of Southern Medical University， Cardiology Section of Shantou Chaoyang Hospital in Guangdong Province， Shantou 515154， China 　　[Abstract] Our country has 8 million - 10 million patients with AF， which caused by the stroke of AF is 24.8%， this is the glorious mission and a long way for medical workers. In recent years， medical workers have made gratifying achievements on AF basic and clinical research， and also appeared many new luminescent spots on it. such as finding the entrance of the upper left pulmonary vein sleeves cells， catheter left closure or ligation which can cure most of the patients with paroxysmal AF； Clinically， the strengthen management of HBP， losing weight， taking ACEI and ARB and statins can prevent AF； Antithrombotic treatment has the new progress on the curing of AF patients who are with the mechanical cardioerter， the Radiofrequency ablation and drug cardioerter. 　　[Key words] Atrial fibrillation； Refactoring； Heart rate/rhythm of the heart； Amiodarone art； Thrombotic 　　心房颤动（AF）和心力衰竭是21世纪心血管领域中的两大难题，尚未攻克的巨大堡垒。前者导致严重的心房律紊乱，相继泵血功能恶化，且常引起脑及全身栓塞（Embolism），增加体力衰弱，使心脑血管病患者残废、死亡的风险增加，给人类健康带来严重的威胁。2013 ESC大会主席、TRI负责人、伦敦大学学院AKKAKKA教授说：“世界每年新发生AF 1500万例，其中20%的患者引起血栓”。中国AF患者达800万例，约1/3患者发生血栓，是无AF患者发生脑卒中的5倍。 　　神经重构、电生理重构、心房肌重构等，是AF发生和维持的基质，在某些触发因子刺激交感神经、副交感神经、心率及节律发生非正常的改变，A-V旁路和房室的