心房颤动患者血浆超敏C反应蛋白水平变化的临床研究

The clinical study of serum level of high sensitivity-C-reactive protein in patients with atrial fibrillation

目的:探讨炎症反应在心房颤动(房颤)发生与维持中的作用。方法:2007年1月-2009年10月在我院心血管内科住院的房颤患者90例,按照房颤持续时间分为阵发性房颤组(22例)、持续性房颤组(28例)和永久性房颤组(40例);对照组78例为同期住院的窦性心律的患者。各组患者于入院后24～48 h测定血清超敏C-反应蛋白(hs-CRP)水平,超声心动测定左房内径。结果:阵发性房颤组患者hs-CRP为(5.98±2.01)mg/L,明显高于对照组(2.07±0.48)mg/L(P<0.05);持续性房颤组hs-CRP为(10.32±3.14)mg/L,明显高于阵发性房颤组(P<0.05);永久性房颤组hs-CRP为(2.20±0.86)mg/L明显低于持续性组(P<0.05),且与对照组比较差异无统计学意义。永久性房颤组左房内径大于持续性房颤组和对照组(P<0.05);持续性房颤组左房内径大于阵发性房颤组(P<0.05)。结论:hs-CRP水平在房颤发生早期明显升高,随房颤持续时间延长逐渐下降至正常,提示炎症反应在房颤发生与维持中起一定作用;随房颤持续时间的延长,左房内径逐渐扩大,提示房颤的维持与心房结构重构关系密切。

Objective： To investigate the role of inflammation in the occurrence and development of atrial fibrillation （AF）. Methods： Ninety patients with AF admitted and treated in the Cardiology Department of the First Hospital Affiliated to the Chinese PLA General Hospital from January 2007 to October 2009 were retrospectively reviewed and studied. The patients were divided into three groups： paroxysmal AF group（22 cases）,persistent AF group（28 cases）, and permanent AF group（40 cases）. Besides, 78 patients of sinus arrhythmia admitted during the corresponding period were enrolled as the control group. Serum levels of high sensitivity C-reactive protein （hs- CRP） were compared among the groups and left atrial diameter in each patient was measured. Results： Serum level of hs-CRP in paroxysmal AF group [（5.98±2.01）mg/L] was higher than that in normal control group[（2.07± 0. 48）mg/L,P〈0. 05]. Serum levels of hs-CRP in the persistent AF group [（10.32±3.14）mg/L] was higher than that in the paroxysmal AF group（P〈0. 05）. But serum levels of hs-CRP in permanent group [（2.20±0.86） mg/L] was lower than that of the persistent group（P〈0.05） ,and approximated to the levels of the control group （P〉0. 05）. Left atrium diameter of the permanent AF group was larger than that of the persistent AF group and the control group, while that of the persistent group was larger than that of the paroxysmal group（P〈0. 05）. Conelusion： Serum level of hs-CRP raises quickly in the early period of AF,but it gradually dropped along with the development of AF, indicating that inflammation may play an important role in the occurrence and development of AF. Left atrium diameter obviously increases with the development of AF,indicating a close relation between atrial structural remodeling and AF.