超敏C反应蛋白与阵发性房颤射频消融术后早期复发的关系

The relationship between high-sensitivity C-reactive protein (hsCRP) levels and atrial fibrillation early recurrence after paroxysmal atrial fibrillation radiofrequency catheter ablation

目的:前瞻性研究超敏C反应蛋白(hsCRP)与阵发性心房颤动射频消融术后早期复发的关系。方法:接受CARTO指导房颤射频消融术的非瓣膜性阵发性房颤患者57例,平均年龄(53.32±9.98)岁,其中男42例,女15例。术前及术后5 d连续测定外周血hsCRP和高敏肌钙蛋白T(hs-cTnT)水平,记录体表心电图,行24 h动态心电图检查。术后5 d内,32名患者(56.14%)为窦性心律,为未复发组,25名(43.86%)复发房颤,为复发组。结果:未复发组与复发组患者的hsCRP与hs-cTnT日均升高量显著正相关,P=0.044,r=0.268。而两组间基线临床特征、手术前后血浆hsCRP、hs-cTnT水平、血浆hsCRP及hs-cTnT的总升高量(峰值水平-术前水平)、日均升高量(总升高量/达到峰值所用天数)无明显统计学差异(P均>0.05)。结论:房颤射频消融术后hsCRP升高变化与心肌损伤程度相关,与早期复发无直接关系,尚不能作为预测房颤术后早期复发的高危因子。

Objective： To prospectively clarify the predictive value of high-sensitivity C-reactive protein （hsCRP） on the risk for recurrent atrial an＇hythmia in paroxysmal atrial fibrillation （PAF） population who accepted radiofrequency catheter ablation （RFCA） of atrial fibrillation （AF）. Methods： There were 57 consecutive patients （53.32±9.98 years; 42 males） with drug-refractory PAF who underwent RFCA were included. Plasma levels of hsCRP and high-sensitivity cardiac troponin T （hs-eTnT） were measured on admission and first five days after PF- CA. Twenty-tire patients （43.86%） had early recurrence of atrial fibrillation （ERAF）. Results： Compared to patients without ERA F （no-AFrecurrence group） , baseline hsCRP levels had no significant diffrence in patients with ERAF （AF recurrence group）. There were no significant differences in the peak hsCRP and hs-eTnT levels between no-AF-recurrenee group and AF recurrence group. However, change of hsCRP level was significantly correlated with change in hs-eTnT level in patients undexgoing RFCA （ r = 0. 268, P = 0. 044）. Conclusion： Among those AF patients undergoing ablation, change of hsCRP level could be for the myoeaMial injury related to RFCA procedure, which may not be a risk factor to predict ERAF. The variety of hsCRP level may be related to the degree of myocardial injury induced hy RFCA.