摘要
目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)对阵发性心房颤动(房颤)患者导管消融术后复发的预测价值。方法连续选取2014年1月至2015年12月于武汉大学中南医院行导管消融术的阵发性房颤患者164例。房颤复发定义为消融3个月后发生持续30 s以上的快速房性心律失常。根据消融术前的MHR水平将患者分为MHR≤0.54组和MHR>0.54组,并比较两组患者的临床资料。采用Cox回归分析探究影响房颤复发的因素。结果平均随访时间为(18.9±7.7)月,期间共53例(32.3%)患者复发。MHR>0.54组患者的房颤复发率为43.9%(36/82),而MHR≤0.54组患者为20.7%(17/82),差异具有统计学意义(Log-rank P<0.01)。Pearson相关性分析表明,MHR水平与房颤病程、左房内径和高敏C反应蛋白水平呈正相关。多因素Cox回归分析结果表明,MHR(HR=1.62,95%CI:1.13~2.13;P<0.01)、左房内径(HR=1.40,95%CI:1.05~1.86;P=0.021)和早期复发(HR=2.13,95%CI:1.25~3.63;P<0.01)是消融术后房颤复发的独立预测因素。结论阵发性房颤导管消融术前的MHR水平与术后复发密切相关,可作为预测房颤复发的指标。
Objective To investigate the predictive value of monocyte to high-density lipoprotein-cholesterol(MHR) ratio for recurrence of paroxysmal atrial fibrillation(AF) after catheter ablation. Methods AF patients(n=164) undergone catheter ablation were chosen continuously from Zhongnan Hospital of Wuhan University from Jan. 2014 to Dec. 2015. The recurrence of AF was defined as occurrence of rapid atrial arrhythmias(duration≥30 s) after catheter ablation for 3 months. The patients were divided, according to MHR level before catheter ablation, into MHR≤0.54 group and MHR>0.54 group. The clinical data was compared between 2 groups. The influencing factors of AF were studied by using Cox regression analysis. Results The average follow-up period was(18.9±7.7) months, and during this period there were 53 cases(32.3%) with AF recurrence. The recurrence rate of AF was 43.9%(36/82) in MHR>0.54 group and 20.7%(17/82) in MHR≤0.54 group(Log-rank P<0.01). The results of Pearson correlation analysis showed that MHR level was positively correlated to AF course, left atrial diameter(LAD) and high-sensitivity C-reactive protein(hs-CRP). The results of multi-factor Cox regression analysis showed that MHR(HR=1.62,95%CI:1.13~2.13;P<0.01), LAD(HR=1.40,95%CI:1.05~1.86;P=0.021) and early recurrence(HR=2.13,95%CI:1.25~3.63, P<0.01) were independent predictive factors of AF recurrence after catheter ablation. Conclusion The level of MHR in AF patients before catheter ablation is closely correlated to post-operation recurrence, which can be taken as a predictor for AF recurrence.
作者
雷倩
魏宝柱
Lei Qian;Wei Baozhu(Department of Cardiology,Zhongnan Hospital,Wuhan University,Wuhan 430071,China.)
出处
《中国循证心血管医学杂志》
2019年第10期1225-1228,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
单核细胞/高密度脂蛋白胆固醇比值
心房颤动
导管消融
复发
Monocyte to high-density lipoprotein-cholesterol ratio
Atrial fibrillation
Catheter ablation
Recurrence
