阵发性心房颤动射频消融术和血清C反应蛋白水平的关系

The association between radiofrequency catheter ablation of paroxysmal atrial fibrillation and serum C-reactive protein

目的探讨阵发性心房颤动(房颤)射频消融术后1个月内复发与炎症反应的关系。方法 54例阵发性房颤患者初次行射频消融术。根据术后1个月内是否复发分为复发组(A组,22例)和未复发组(B组,32例)。测定术前、术后3d、1周、2周和1个月超敏C反应蛋白(hs-CRP)水平。结果两组术后的hs-CRP均明显高于术前(P<0.05)。A组术后3d、1周和2周的hs-CRP均明显高于B组[(19.2±5.7)mg/L vs.(15.2±6.0)mg/L、(53.2±9.7)mg/L vs.(46.3±8.5)mg/L和(23.8±7.8)mg/L vs.(19.8±6.1)mg/L](P<0.05)。多因素回归分析显示,hs-CRP手术前后最大差值是房颤术后1个月内复发的独立危险因素。结论房颤术后1个月内复发的患者hs-CRP明显升高,提示射频消融损伤心肌组织引起的急性炎症过程可能是其重要机制。

Objective To investigate the association between inflammatory response and recurrence of atrial fibrillation（AF） within 1 month after radiofrequency catheter ablation（RFCA）.Methods Of 54 AF patients underwent RFCA,22 cases（group A） had a recurrence of AF within 1 month after RFCA and 32 cases（group B） did not.Serum concentrations of high sensitive C-reactive protein（hs-CRP） were measured before,at 3 days,1 week,2 weeks and 1 month after ablation.ResultsCompared to before,serum levels of hs-CRP were significantly increased within 1 month after RFCA（P0.05）.On the 3rd day,in the 1st week and 2nd week after ablation,serum levels of hs-CRP were significantly higher in group A than those in group B [（19.2±5.7） mg/L vs.（15.2±6.0） mg/L、（53.2±9.7） mg/L vs.（46.3±8.5） mg/L and（23.8±7.8） mg/L vs.（19.8±6.1） mg/L]（P0.05）.The binary logistic regression analysis showed that the maximum difference of before and after RFCA in hs-CRP was an independent risk factor for AF recurrence within 1 month.ConclusionThe patients with AF recurrence within 1 month after RFCA has a higher serum hs-CRP level,which indicates that acute inflammatory response induced by ablation may be responsible for myocardiac injury after RFCA.