心房颤动射频消融治疗的临床疗效及C反应蛋白对远期不良事件的预测价值

Clinical efficacy of radiofrequency ablation in the treatment of atrial fibrillation and the predictive value of C reactive protein for long-term adverse events

目的:对比射频消融手术与口服药物治疗心房颤动(AF)远期不良事件发生率,进一步分析C反应蛋白(CRP)对AF病人远期不良事件的预测价值。方法:选取蚌埠医学院第一附属医院门诊或住院AF病人,其中行射频消融治疗89例,口服药物治疗107例,对2组病人进行约18个月的长期随访,评估2组病人长期脑卒中、出血事件、全因死亡的发生情况;同时根据病人入院前相关指标评估各项指标,应用COX回归分析预测远期不良事件的风险因子,评估CRP是否为AF远期不良事件的预测因子。结果:AF射频消融治疗远期脑卒中、出血事件、全因死亡及所有事件均少于药物治疗组,且射频消融组发生不良事件的时间慢于药物治疗,但2组差异无统计学意义(P>0.05);CRP是AF病人远期不良事件的独立预测因子,血清CRP≥6.4 mg/L与AF远期不良事件发生率有关。结论:CRP水平可作为AF病人远期不良事件的预测因子,且可凭借CRP水平筛选出AF病人高风险人群。

Objective:To compare the incidence rate of long-term adverse events between radiofrequency ablation and oral drug therapy for atrial fibrillation(AF),and further analyze the predictive value of C reactive protein(CRP)in long-term adverse events of AF patients.Methods:The patients with AF in the First Affiliated Hospital of Bengbu Medical College were selected,89 patients were treated with catheter ablation,and 107 patients were treated with oral medication.Two groups were followed up for 18 months,and the incidence rate of chronic stroke,bleeding events and all-cause death in two groups were evaluated.The indicators in two groups were evaluated according to the pre-admission related indicators.The Cox regression analysis was used to predict the risk factors of long-term adverse events,and whether CRP for a predictor of AF long-term adverse events was evaluated.Results:The long-term stroke,bleeding events,all-cause death and all events in the patients treated with radiofrequency ablation were less than those in the patients treated with drug.The adverse events time in the radiofrequency ablation group was little compared with in the drug therapy group,but the difference of which was not statistically significant(P>0.05).The CRP was an independent predictor of long-term adverse events in AF patients,and the serum CRP≥6.4 mL/L was associated with the incidence rate of long-term adverse events in AF patients.Conclusions:The CRP level can be used as a predictor of long-term adverse events,and the high-risk population of patients with AF can be screened using CRP level.