血浆转化生长因子β1水平与心房颤动导管消融后复发的关系研究  

Relationship Between Pre-Operative Plasma Transforming Growth Factor-β1 Level and Recurrence of Atrial Fibrillation in Patients After Catheter Ablation

作　　者：吴钢[1] 顾永伟[1] 程冕[2] 黄鹤[1] 杨波[1] 蒋学俊[1] 江洪[1] 黄从新[1] 

机构地区：[1]武汉大学人民医院心内科,湖北省武汉市430060 [2]华中科技大学同济医学院附属同济医院综合科

出　　处：《中国循环杂志》2013年第1期40-43,共4页Chinese Circulation Journal

基　　金：国家自然科学基金项目;项目编号:81270305;国家科技支撑计划课题;项目编号:2011BAI11B12;武汉大学研究生自主科研项目;项目编号:201130202020003

摘　　要：目的:探讨心房颤动(房颤)导管消融术前患者血浆转化生长因子β1(TGF-β1)水平与房颤消融术后复发的关系。方法:连续选取100例接受导管消融治疗的房颤患者,其中阵发性房颤60例,持续性房颤40例。阵发性及持续性房颤患者随访1年后根据房颤复发情况再分为复发组和无复发组。术前检测血浆TGF-β1水平,并行超声心动图等临床检查。结果:所有患者均随访12个月,房颤消融术后的复发率为30%(30/100),其中阵发性房颤术后复发率为21.6%(13/60),持续性房颤复发率为42.5%(17/40)。30例房颤术后复发患者术前血浆TGF-β1水平较70例术后无复发患者高[(35.49±8.47)ng/ml vs(27.00±8.61)ng/ml),P<0.05],其中阵发性房颤复发组术前血浆TGF-β1水平较无复发组高,差异有统计学意义[(28.90±8.44)ng/ml vs(22.47±6.64)ng/ml,P<0.05];持续性房颤复发组亦高于无复发组[(40.52±3.37)ng/ml vs(36.26±2.66)ng/ml,P<0.05]。对患者年龄、性别、房颤类型、体重指数、左心房内径、左心室射血分数、TGF-β1等多因素logistic回归分析得出术前血浆TGF-β1水平与房颤消融术后复发有关[OR=1.17,95%CI(1.05,1.31),P=0.004]。进一步分析显示,术前血浆TGF-β1水平与阵发性房颤的术后复发有关[OR=1.16,95%CI(1.05,1.52),P=0.01],与持续性房颤术后复发也有关[OR=1.71,95%CI(1.12,2.62),P=0.013]。结论:房颤消融术前血浆TGF-β1水平与房颤消融术后复发有关。Objective：To investigate the relationship between pre-operative plasma transforming growth factor-β1 （TGF-β1） level and recurrence of atrial fibrillation （AF） in patients after catheter ablation. Methods ：A total of 100 consecutive AF patients were studied,60 of them with paroxysmal AF and 40 with persistent AF, all patients received catheter ablation. The patients were fallowed-up for 1 year, and then, divided as Recurrence group and Non- recurrence group. The pre-operative plasma TGF-β1 level, echocardiography and other clinical examinations were conducted in all patients. Results：During 12 months fallow-up period,the total AF recurrence rate was 30% （30/100） including 21.6% （13/60） of paroxysmal AF and 42. 5% （17/40） of persistent AF. TGF-β1 level in Recurrence group was higher than that in Non-recurrence group, （ 35.49±8.47 ） ng/ml vs. （ 27.00±8.61 ） ng/ml, P〈0. 05. In paroxysmal AF patients, TGF-β1 level in AF recurrence pa- tients was higher than that in non-recurrence patients, （28.90±8.44）ng/ml vs. （22. 47±6. 64 ） ng/ml, P〈0. 05 ;and in persistent AF patients, TGF-131 level in recurrence patients was higher than that in non-recurrence patients, （40. 52 ±3.37 ）ng/ml vs. （36. 26±2. 66）ng/ml,P〈0. 05. Multivariate Logistic regression analysis presented that increased TGF-β1 level was significantlyrelated to AF recurrence, OR = 1.17,95 % CI 1.05,1.31, P = 0. 004 ;further investigation indicated that TGF-β1 level also related to paroxysmal AF recurrence, OR = 1.16,95 % C I 1.05,1.52, P = 0.01 and to persistent AF recurrence OR = 1.71,95 % CI 1.12, 2. 62,P=0. 013.Conclusion：Pre-operative plasma TGF-β1 level related to AF recurrence in patients after catheter ablation.

关 键 词：转化生长因子Β1 心房颤动 导管消融 复发 

分 类 号：R54[医药卫生—心血管疾病]