心房颤动导管消融术后早期复发与炎症反应的关系  

Association between inflammatory response and early recurrence of atrial fibrillation after catheter ablation

作　　者：刘书旺[1] 米琳[1] 佘飞[1] 孙超[1] 曾辉[1] 杨洪涛[1] 高炜[1] 

机构地区：[1]北京大学第三医院心内科,分子心血管学教育部重点实验室,100191

出　　处：《中国介入心脏病学杂志》2010年第4期181-184,共4页Chinese Journal of Interventional Cardiology

基　　金：国家重点基础研究发展计划("973计划"课题;2007CB512107)

摘　　要：目的探讨心房颤动(房颤)导管消融术后早期复发与炎症反应的关系。方法选择2008年10月至2009年7月于北京大学第三医院接受导管消融治疗的房颤患者28例,分别测定并比较消融术前、术后即刻及术后3天血浆高敏感性C反应蛋白(hs-CRP)和白介素-6(IL-6)水平,并对房颤消融术后早期复发与未复发患者间不同时间点的炎症因子水平进行比较。结果房颤患者消融术后3天血浆hs-CRP和IL-6水平均显著高于术前和术后即刻水平(P<0.001)。6例消融术后早期复发的房颤患者术后3天血浆IL-6水平显著高于未复发组(0.57×10-12mmol/L比0.25×10-12mmol/L,P=0.014),而hs-CRP水平两组间差异无统计学意义(P>0.05)。复发组血浆hs-CRP和IL-6水平术后3天和术前差值均显著高于未复发组(4.11×10-3mmol/L比1.75×10-3mmol/L,P=0.044;0.38×10-12mmol/L比0.08×10-12mmol/L,P=0.004)。复发组血浆hs-CRP和IL-6术后3天水平较术前水平增加的倍数也显著高于未复发组(5.80比0.98,P=0.019;2.80比0.92,P=0.016)。结论房颤导管消融术后3天开始出现明显炎症反应,房颤早期复发患者术后3天血浆IL-6水平显著高于未复发患者,且复发患者血浆hs-CRP和IL-6水平术后3天较术前上升的幅度及增加的倍数显著高于未复发患者,这对消融术后早期房颤复发可能具有一定的预测价值。Objective To investigate the association between inflammatory response and early recurrence of atrial fibrillation（AF）after catheter ablation.Methods Twenty-eight patients with AF undergoing catheter ablation were prospectively enrolled.Each patient had plasma levels of high sensitive C- reactive protein（hs-CRP）and interleukin-6（IL-6）drawn 30 minutes prior to ablation,immediately and on day 3 after ablation.The serial changes of plasma hs-CRP and IL-6 levels were observed and the values of the two inflammatory factors in patients with early recurrent AF（ERAF）and those in patients without ERAF were compared.Results Plasma hs-CRP and IL-6 levels were significantly higher on day 3 after ablation than those drawn prior to ablation or immediately after ablation in AF（P 0.001）.Of 28 AF patients undergoing catheter ablation,6 had evidence of ERAF within 3 months after ablation.Plasma IL-6 levels on day 3 were significantly higher in patients with ERAF than in patients without ERAF（0.57 vs.0.25,P = 0.014）,while there was no significant difference in hs-CRP levels between the two groups（P 0.05）.The differences of Plasma hs-CRP and IL-6 levels between day 3 after ablation and prior to ablation were respectively significantly higher in patients with ERAF than that in patients without ERAF（4.11 vs.1.75,P = 0.044;0.38 vs.0.08,P = 0.004）.The increasing multiples of Plasma hs-CRP and IL-6 levels between day 3 after ablation and prior to ablation were also respectively significantly higher in patients with ERAF than that in patients without ERAF（5.80 vs.0.98,P = 0.019;2.8 vs.0.92,P = 0.016）.Conclusion A remarkable inflammatory response was noted on day 3 after catheter ablation in AF patients.Plasma IL-6 levels on day 3 were significantly higher in patients with ERAF than in patients without ERAF.The differences and increasing multiples of Plasma hs-CRP and IL-6 levels between day 3 after ablation and prior to ablation were respectively significantly higher in patients with ERAF than that in p

关 键 词：心房颤动 导管消融术 炎症 C反应蛋白质 白介素6 

分 类 号：R541.7[医药卫生—心血管疾病]