单核细胞与高密度脂蛋白胆固醇比值对射频消融术后晚期心房颤动复发的预测价值

Value of monocyte/HDL-C ratio in predicitng recurrence of late AF after radiofrequency ablation

目的探讨单核细胞/HDL-C比值(MHR)对老年阵发性心房颤动(房颤)患者射频消融术后晚期复发的预测价值。方法纳入江苏省苏北人民医院行导管射频消融术的老年阵发性房颤患者82例,根据消融术3个月后房颤是否复发分为复发组31例和未复发组51例,收集入选患者术前临床资料,采用logistic回归分析术后复发的影响因素。结果老年阵发性房颤行射频消融术患者术后晚期复发率为37.8%,复发组房颤病程、单核细胞、MHR及左心房内径明显高于未复发组,HDL-C明显低于未复发组,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,校正相关因素后,左心房内径和MHR是阵发性房颤射频消融术后晚期复发的独立危险因素(OR=1.280,95%CI:1.079~1.518,P=0.005;OR=1.482,95%CI:1.153~1.906,P=0.002)。ROC曲线分析显示,MHR预测阵发性房颤射频消融术后晚期复发的曲线下面积为0.76(95%CI:0.650~0.870,P=0.000)。结论MHR是老年阵发性房颤患者射频消融术后晚期复发的独立预测因素。

Objective To study the value of monocyte/HDL-C ratio(MHR)in predicitng the recurrence of late paroxysmal AF in the elderly after radiofrequency ablation(RFA).Methods Eighty-two elderly paroxysmal AF patients who underwent catheter RFA in North Jiangsu People’s Hospital were divided into recurrence group(n=31)and recurrence-free group(n=51).Their clinical data before RFA were recorded and the influencing factors of recurrent paroxysmal AF after RFA were analyzed by logistic regression analysis.Results The recurrence rate of late paroxysmal AF in the elderly after RFA was 37.8%.The duration of paroxysmal AF and the inner diameter of left atrium were significantly longer,the MHR was significantly higher while the serum HDL-C level was significantly lower in recurrence group than in recurrence-free group(P<0.05,P<0.01).Logistic regression analysis showed that inner diameter of left atrium and MHR after adjustment for related factors were the independent risk factors for the recurrence of late paroxysmal AF in the elderly after RFA(OR=1.280,95%CI:1.079-1.518,P=0.005;OR=1.482,95%CI:1.153-1.906,P=0.002).ROC curve analysis displayed that the AUC for MHR in predicting the recurrence of late paroxysmal AF in the elderly after RFA was 0.76(95%CI:0.650-0.870).Conclusion MHR is an independent predictor for the recurrence of late paroxysmal AF in the elderly after RFA.