P波离散度和超敏C反应蛋白在阵发性心房颤动中的预测价值及胺碘酮对其影响

Predictive Value of P Wave Dispersion and High Sensitive C-reactivel Protein and Effect of Amiodarone in Patients with Paroxysmal Atrial Fibrillation

目的探讨P波离散度(Pd)和超敏C反应蛋白(hs-CRP)在阵发性心房颤动(PAF)中的预测价值及胺碘酮对其影响。方法对60例健康者(对照组)和60例PAF患者(观察组,服药前及经胺碘酮治疗2个月后)测定Pd和hs-CRP。观察组根据服药前、后hs-CRP水平将患者分为hs-CRP<3.0 mg.L-1组和hs-CRP≥3.0 mg.L-1组,再依据服药前、后Pd的变化将患者分为Pd<40 ms组和Pd≥40 ms组;服药前或服药患者以停用胺碘酮1个月后开始,随访PAF患者3个月,了解其心房颤动(房颤)复发情况。结果观察组服用胺碘酮前的Pd、hs-CRP水平显著高于对照组(P<0.001);服用胺碘酮后的Pd、hs-CRP水平与服用胺碘酮前明显降低(P<0.001),与对照组比较差异无统计学意义(P>0.05)。服药前及服药后hs-CRP<3.0 mg.L-1组的房颤复发率低于hs-CRP<3.0 mg.L-1组(P<0.025或P<0.005),Pd<40 ms组房颤复发率低于Pd≥40 ms组(P<0.005)。结论 Pd和hs-CRP水平能对PAF的复发有较好的预测价值,胺碘酮可以显著降低PAF复发。

Objective To investigate the predictive value of P wave dispersion（Pd） and high sensitive C-reactive protein（hs-CRP） and the effect of amiodarone in patients with paroxysmal atrial fibrillation（PAF）.Methods Pd and plasma high sensitive C-reactive protein levels were measured in 60 healthy subjects（control group） and 60 PAF patients（observation group）.According to the levels of hs-CRP before and 2 months after amiodarone treatment,the patients with PAF were further divided into hs-CRP〈3.0 mg·L-1 group and hs-CRP≥3.0 mg·L-1group.According to Pd before and after amiodarone treatment,the PAF patients were divided into Pd〈40 ms group and Pd≥40 ms group.The patients were followed up for 3 months before or after 1 month of amiodarone treatment to observe the recurrence of PAF.Results Compared with control group,Pd and hs-CRP levels significantly increased in PAF patients before amiodarone treatment（P〈0.001）,but did not change in observation group after amiodarone treatment（P〉0.05）.In addition,Pd and hs-CRP levels were obviously increased by amiodarone in patients with PAF（P〈0.001）.Before and after amiodarone treatment,the recurrence rate of atrial fibrillation in hs-CRP〈3.0 mg·L-1 group was lower than that in hs-CRP≥3.0 mg·L-1 group（P〈0.025 or P〈0.005）,and the recurrence rate in Pd40 ms group was lower than that in Pd ≥ 40 ms group（P〈0.005）.Conclusion Pd and plasma hs-CRP levels may be good predictors of PAF recurrence.Amiodarone can significantly reduce the recurrence rate of PAF.