阵发性心房颤动患者CRP水平及与RFCA后心房颤动复发的相关性分析

An analysis of corrlation between CRP levels and recurrence of atrial fibrillation after radiofrequency ablation in patients with paroxysmal atrial fibrillation

目的探讨阵发性心房颤动(房颤)患者CRP水平及与射频消融术(RFCA)后房颤复发的相关性。方法回顾性分析首次行RFCA的155例阵发性房颤患者临床资料,术后随访时间大于3个月,根据房颤是否复发分为复发组(27例)和未复发组(128例)。调整不同变量行多因素logistic回归分析影响阵发性房颤患者RFCA后房颤复发的独立危险因素。绘制ROC曲线评估术前CRP水平对阵发性房颤患者RFCA后房颤复发的预测价值。结果两组患者术前CRP水平、房颤病程、LVEF、高脂血症比例比较均有统计学差异(P<0.05)。多因素logistic回归分析显示,术前高CRP水平是阵发性房颤患者RFCA后房颤复发的独立危险因素(P<0.05)。ROC曲线分析结果显示,术前CRP水平预测阵发性房颤患者RFCA后房颤复发的AUC为0.662[95%CI(0.534~0.790),P<0.05],取4.15 mg/L为RFCA后房颤是否复发的最佳预测界值,对应的预测灵敏度为39.1%,特异度为86.5%。结论阵发性房颤患者术前CRP水平有可能作为RFCA后房颤复发的预测指标。

Objective To analyze the correlation between C-reactive protein(CRP)levels and recurrence of atrial fibrillation(AF)after radiofrequency ablation(RFCA)in the patients with paroxysmal AF.Methods The clinical data of 155 patients with paroxysmal AF underwent RFCA for the first time were retrospectively analyzed.The patients were followed up for more than 3 months after surgery.The patients were divided into two groups of A(with AF recurrence,27 cases)and B(without AF recurrence,128 cases).Multivariate logistic regression analysis was conducted by adjusting for different variables to identify the independent risk factors for AF recurrence.The ROC curve was plotted to evaluate the value for the preoperative CRP level to predict AF recurrence after RFCA.Results There were statistical differences in the preoperative CRP level,duration of AF,left ventricular ejection fraction,and proportion of hyperlipidemia between the two groups(P<0.05).Multivariate logistic regression analysis showed that high preoperative CRP level was an independent risk factor for AF recurrence after RFCA(P<0.05).The ROC curve analysis results showed that the AUC of preoperative CRP level predicting AF recurrence in the patients with paroxysmal AF after RFCA was 0.662[95%CI(0.534-0.790),P<0.05].Taking 4.15 mg/L as the optimal cuttoff value of CRP predicting AF recurrence after RFCA,the sensitivity was 39.1%,and the specificity was 86.5%.Conclusion The preoperative CRP level in the patients with paroxysmal AF is possible to serve as a predictive indicator for AF recurrence after RFCA.