摘要
目的了解经导管射频消融患者乙型肝炎病毒(HBV)感染情况,探讨重复使用消融导管的安全性。方法采用ELISA法对部分重复使用消融导管的440例随访患者[平均(32±25)个月]行HBV血清学5项指标(两对半)及肝功能检测,检验结果与术前资料比较。结果本组患者术后HBV总感染率为4682%(206/440),与术前2363%(104/440)相比差异有显著性(P<005),但并不高于一般社会人群HBV总感染率(576%);术后HBsAg阳性率为432%(19/440),与术前409%(18/440)相比差异无显著性(P>005);术后抗HBs阳性率为3659%(161/440),与术前1956%(86/440)相比差异具有显著性(P<005);术后抗HBs、抗HBe和抗HBc同时阳性33例,阳性率为750%,与术前114%(5/440)相比差异有显著性(P<005)。随访发现无一例术前HBV阴性而术后携带HBV病毒,也无一例有临床肝病表现,肝功能与术前相比差异无显著性(P>005)。结论重复使用消融导管虽然增加了感染HBV的机会,但总的转归是好的,部分患者术后产生了保护性抗体。
Objective To investigate the status of hepatitis B virus (HBV) infection in patients after radiofrequency catheter ablation (RFCA),and to discuss the security of reusing the ablation catheter.MethodsLiver functions and five items of HBV serology were tested with ELISA in 440 patients who had reused catheter ablation procedure at mean follow up of (32±25) months after RFCA.Comparative statistic study was performed in this study.Results There is significant difference( P <0 05) between the HBV infection rate pre RFCA[23 64%(95/431)] with that post RFCA [46 82%(216/431)].HBsAg positive rate after RFCA is 4 32%(19/440) while 4 09%(18/440) before RFCA.The difference is not significant ( P >0 05).Anti HBs positive rate after RFCA is 36 59%(161/440),while 19 56%(86/440) before RFCA.The difference is significant ( P <0 05).Thirty three cases with anti HBs、anti HBe and anti HBc positive after RFCA were found,the rate is 7 50%,while 1 15%(5/440) before RFCA.The difference is significant( P <0 05).No patient had the clinic liver disease,and no patient whose HBV was negative before RFCA developed HBV positive.In all patients the liver function post RFCA is not different from that pre RFCA.Conclusions Reusing ablation catheter may increase the incidence of HBV infection,but no clinical hepatitis will be developed and 36 59% of cases developed anti HBs positive,a protective antibody,after RFCA.
出处
《中华心律失常学杂志》
2004年第5期304-307,共4页
Chinese Journal of Cardiac Arrhythmias
