Circ-Arrhythmia Elec:肉毒杆菌或可有效防止心脏搭桥患者术后房颤的发生

2015-10-21 sunshine 译 MedSci原创

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据发表于Circulation: Arrhythmia and Electrophysiology的一项新的研究表明,肉毒杆菌(众所周知可减少面部的皱纹)可预防患者心脏搭桥术后注入脂肪时房颤的发生。

肉毒杆菌毒素是由肉毒杆菌所产生,当注入少量的肉毒杆菌毒素至肌肉中时,毒素可阻断神经的信号传导,引起肌肉收缩。

房颤(AF)最常见的心律失常之一,可导致血栓、中风、心脏衰竭及其他心脏并发症的发生。

“约三分之一的患者接受心脏搭桥术后出现房颤,使得这些患者处于心血管并发症的高危之中,” Jonathan S. Steinberg博士说道,“房颤通常或延长患者的住院时间,增加其治疗费用。”

该研究中研究人员纳入了60名患者,双盲随机分配患者接受肉毒杆菌毒素或生理盐水注射治疗。注射部位为心脏周围的四个大的脂肪垫部位。

结果发现,搭桥术后30天,术中接受肉毒杆菌毒素注射治疗的患者发生AF的概率为7%,而接受生理盐水注射治疗的患者发生AF的概率为30%。术后一年,接受肉毒杆菌毒素治疗的患者无一发生AF,而接受生理盐水治疗的患者中有27%的发生了AF。患者也并未出现因注射肉毒杆菌毒素而出现并发症。但是此二组患者因接受搭桥手术而出现的并发症,如重症监护以及呼吸机使用的时间,感染率等类似。

但是,在肉毒杆菌毒素真正用于预防搭桥术后AF的发生之前,仍需进行更大样本量的研究以证实本研究的结果。若可证实,那么肉毒杆菌毒素治疗或可帮助正要接受瓣膜修复或置换患者预防AF的发生。约一半的患者接受心脏搭桥术后可发生AF。

“该研究在人类研究中开辟了一条新的思路和研究,” Steinberg说道,“在不久的将来,肉毒杆菌毒素注射或可成为心脏搭桥术的瓣膜病患者护理的标准,但是目前我们还没有做到这一点。”

原始出处:

Botox may prevent irregular heartbeat after bypass surgery. Science Daily, October 20, 2015.

Evgeny Pokushalov, Boris Kozlov, et al. Long-Term Suppression of Atrial Fibrillation by Botulinum Toxin Injection into Epicardial Fat Pads in Patients Undergoing Cardiac Surgery: One Year Follow Up of a Randomized Pilot Study. Circulation: Arrhythmia and Electrophysiology, October 2015 DOI:10.1161/CIRCEP.115.003199


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