心房颤动患者射频消融术前术后炎症因子IL-6、IL-8与hs-CRP的变化

Changes of plasma IL-6,IL-8 and hs-CRP in patients with atrial fibrillation before and after radiofrequency catheter ablation

目的:观察心房颤动(AF)患者射频消融术前、术后1年不同时期相关炎症因子的变化,以及此种变化趋势对房颤复发的影响。方法:42名临床诊断AF的患者,于射频消融术前、术后1、3、9和12个月抽取外周血,通过酶联免疫吸附试验测定高敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6和IL-8的浓度。20例同期体检健康人作为正常对照组。结果:射频消融术前,AF患者hs-CRP、IL-6和IL-8水平明显高于正常对照组(P<0.05)。AF患者hsCRP水平在术后1个月较术前有明显下降(P<0.05),术后3个月趋于稳定。AF组IL-6、IL-8水平在术后3个月明显上升(P<0.05),术后9个月均明显下降(P<0.05),术后12个月趋于稳定。AF术后3个月内早期复发者与未复发者比较IL-6、IL-8水平前者较后者明显升高(P<0.05);88%比例的患者在之后长期随访中未再发生AF。术后12个月晚期复发者与未复发者相比IL-6、IL-8水平无统计学差异。AF复发者与未复发者hs-CRP水平差异未达统计学意义。结论:AF患者较正常健康人炎症因子IL-6、IL-8与hs-CRP水平均明显增高。射频消融术本身短期内可影响炎症因子表达;AF的转归与炎症因子的长期变化有关。

AIM ： To study the changes of the inflammatory cytokines in patients with atrial fibrillation （AF） in different periods 1 year before and after radiofrequency ablation and to examine the difference in differ ent types of AF and the recurrence of AF. METHODS： Forty-two AF patients were enrolled. All blood plasma were collected by venipuncture before ablation and during months 1, 3, 9 and 12 of follow-up. The levels of hs-CRP and IL-6 and IL-8 were measured by ELISA and 20 normal subjects were selected as control group. RESULTS： The levels of hs-CRP, IL-6 and IL-8 in the AF group were significantly higher than those in the control group before the ablation （ P 〈 0. 05 ）. The levels of hs-CRP in the AF group declined significantly in the first month after the ablation （P 〈 0. 05 ） and the levels became stable in the third month （P 〉 0.05 ）. Changes of the levels of IL-6 and IL-8 in the AF group were significantly different before and after the ablation, increasing in the third month （P 〈 0. 05 ）, declining in the ninth month （P 〈 0. 05 ） and becoming relatively stable at the twelfth month. Significant difference was seen in the changes of IL-6 and IL-8 levels after the ablation in patients with and without recurrence of AF during the third month （P 〈0. 05） and 88% of the patients did not have recurrence thereafter. No statisticallysignificant differences were found in the changes of IL-6, IL-8 and hs-CRP levels in patients with and without recurrence of AF at the twelfth month. CONCLUSION： The levels of inflammatory cytokines IL-6, IL-8 and hs-CRP in paroxysmal and persistent AF patients are higher than those in normal subjects before radiofrequency ablation, suggesting that inflammation plays an important role in the occurrence, develop ment and maintenance of AF. Radiofrequency ablation exerts short-term effect on the expression of in flammatory cytokines. Long-term changes in inflammatory factors are related to the outcome of AF.