射频消融术对高血压合并阵发性房颤患者血生化和心肌标志物水平的影响

Effects of radiofrequency catheter ablation on blood biochemical markers and myocardial markers in patients with hypertension complicated with atrial fibrillation

目的 探讨高血压合并阵发性房颤患者射频消融术(RFCA)后血生化和心肌标志物水平的变化。方法 将该院收治的128例高血压合并阵发性房颤患者按入院先后顺序随机等分为强生组和圣犹达组各64例,两组围术期血生化指标、心肌标志物、消融相关指标及安全性进行比较分析。结果 两组术后1d血清C反应蛋白(CRP)、谷丙转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)水平均明显升高,差异有统计学意义(P<0.05),术后7d均恢复至术前水平;强生组与圣犹达组各时间点血生化指标比较,差异无统计学意义(P>0.05);两组术后1、7d血清肌酸激酶同工酶MB(CK-MB)、肌钙蛋白T(cTnT)均先上升后下降,差异有统计学意义(P<0.05),血清N-末端脑钠肽前体(NT-proBNP)水平均呈下降趋势,差异有统计学意义(P<0.05),强生组与圣犹达组各时间点心肌标志物比较,差异无统计学意义(P>0.05);两组肺静脉隔离(PVI)成功率比较,差异无统计学意义(P>0.05);强生组消融时间、手术时间均少于圣犹达组,差异有统计学意义(P<0.05);两组术后均未出现严重并发症。结论 RFCA对高血压合并阵发性房颤患者安全有效,强生压力消融导管具有手术时间短、消融时间短的优势,临床中应根据患者病情和医院条件进行合理选择。

Objective To explore the changes of blood biochemical markers and myocardial markers in patients with hypertension and paroxysmal atrial fibrillation after radiofrequency catheter ablation (RFCA). Methods 128 cases of patients with hypertension and paroxysmal atrial fibrillation admitted to a hospital were randomly and evenly divided into JNJ group and STJ group 64 cases each according to the order of admission.Perioperative blood biochemical markers,myocardial markers,ablation-related indexes and safety were compared between the two groups. Results The levels of serum C-reactive protein (CRP),alanine transaminase(ALT) and aspartate transaminase (AST) were significantly elevated at 1 day after operation in the two groups,the difference was statistically significant ( P <0.05),and the levels returned to preoperative levels at 7 days after operation.There was no significant difference in blood biochemical markers between JNJ group and STJ group at other time points ( P >0.05).The levels of serum creatine kinase MB (CK-MB) and troponin T (cTnT) were increased first and then decreased at 1 day and 7 days after operation,the difference was statistically significant ( P <0.05),and the level of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was decreased,the difference was statistically significant ( P <0.05),and there was no significant difference in myocardial markers between JNJ group and STJ group at each time point ( P >0.05).There was no significant difference in the success rate of pulmonary vein isolation (PVI) between the two groups ( P > 0.05 ).The ablation time and operative time in JNJ group were lower than those in STJ group,the difference was statistically significant ( P <0.05).There was no serious complications between the two groups. Conclusion RFCA is safe and effective for hypertensive patients with paroxysmal atrial fibrillation,but JNJ ST pressure ablation catheter has the advantages of shorter operative time and ablation time,and clinical selection should be based on the patient′ s condition and hospital conditions.