房颤患者C反应蛋白和降钙素原水平变化及其对药物复律成功的预测价值

Level changes of C-reactive protein and procalcitonin and their predictive values to successful drug cardioversion in patients with atrial fibrillation

目的分析C反应蛋白(CRP)和降钙素原(PCT)在心房颤动(房颤)患者中的变化及其对房颤患者药物复律成功的预测价值。方法入选2013年1月~2017年1月于邯郸市中心医院急诊科收入院的房颤患者94例,其中男性59例,女性35例,年龄(61.79±0.79)岁。选取同期住院既往无房颤病史的窦性心律患者28例为对照组。将房颤患者依据类型分为阵发性房颤组(63例),持续性房颤组(31例)。检测入选者CRP和PCT水平。运用受试者工作特征曲线(ROC)评价CRP、PCT对房颤、阵发性房颤和持续性房颤患者药物复律成功的预测价值。结果与对照组比较,阵发性房颤组和持续性房颤组CRP、PCT水平均升高,差异有统计学意义(P均<0.05)。持续性房颤组较阵发性房颤组CRP和PCT水平均升高,差异有统计学意义(P均<0.05)。房颤患者CRP水平与PCT呈正相关(r=0.465,P<0.01)。药物转复为窦性心律阵发性房颤组为77.78%,持续性房颤组为51.61%。PCT诊断房颤、阵发性房颤及持续性房颤药物复律成功的ROC曲线下面积(AUC)为0.78、0.79、0.73,CRP诊断的AUC为0.72、0.71、0.62。结论房颤患者CRP和PCT升高,其检测对预测房颤患者药物转复成功有一定价值。

Objective To analyze the changes of C-reactive protein （CRP） and procalcitonin （PCT） and their predictive values to successful drug cardioversion in patients with atrial fibrillation （AF）. Methods AF patients （n=94, male 59, female 35 and average age=61.79±0.79） were chosen from the Department of Emergency of Central Hospital of Handan City from Jan. 2013 to Jan. 2017. Meanwhile the patients with normal sinus rhythm （NSR） but without AF history （n=28） were chosen into control group. All AF patients were divided into paroxysmal AF group （n=63） and persistent AF group （n=31）. The levels of CRP and PCT were detected in all subjects. The predictive values of CRP and PCT to successful drug cardioversion were reviewed by using receiver operating characteristic curve （ROC） in all groups. Results Compared with control group, the levels of CRP and PCT increased in paroxysmal AF group and persistent AF group （all P〈0.05）. The levels of CRP and PCT increased in persistent AF group compared with paroxysmal AF group （all P〈0.05）. The level of CRP was positively correlated to level of PCT （r=0.465, P〈0.01） in AF patients. The rate of drug cardioversion to NSR was 77.78% in paroxysmal AF group and 51.61% in persistent AF group. The area under curve （AUC） of ROC in diagnosing successful drug cardioversion by PCT from AF, paroxysmal AF and persistent AF was, respectively, 0.78, 0.79 and 0.73, and AUC of ROC in diagnosing successful drug cardioversion by CRP from AF, paroxysmal AF and persistent AF was, respectively, 0.72、0.71、0.62. Conclusion The levels of CRP and PCT increase in AF patients, which may be valuable to prediction of successful drug cardioversion from AF.