血浆同型半胱氨酸水平与心房颤动导管消融复发的关系  

Relationship Between Plasma Homocysteine Level and Atrial Fibrillation Recurrence in Patients With Catheter Ablation

作　　者：江华[1] 李青[1] 李菊香[1] 李根林[1] 徐旺[1] 俞建华[1] 陈琦[1] 鲍慧慧[1] 胡建新[1] 洪葵[1] 程晓曙[1] 

机构地区：[1]南昌大学第二附属医院心内科,江西省南昌市330006

出　　处：《中国循环杂志》2014年第5期360-362,共3页Chinese Circulation Journal

基　　金：赣鄱"555"人才计划科技部863课题2012AA02A516

摘　　要：目的：探讨血浆同型半胱氨酸（HCY冰平与心房颤动（房颤〉导管消融术后复发的关系。方法：连续选取126例接受导管消融治疗的房颤患者，其中阵发性房颤81例，持续性房颤45例？采用循环酶联免疫吸附法测定其血浆HCY水平，并根据HCY水平分成正常组（HCY5-13μmol／L，n=57）、升高组（HCY13～18μmol／1，n=46）和极高组（HCY〉18μmol／L，n=23）。观察三组3个月、6个月、12个月房颤复发情况。结果：阵发性房颤患者3个月、6个月、12个月极高组房颤复发率均高于正常组（P〈0．05），6个月、12个月极高组房颤复发率高于升高组（P〈0．05），而升高组和正常组比较差异无统计学意义；持续性房颤患者6个月、12个月极高组及升高组房颤复发率均高于正常组（P〈0．05）；对阵发性房颤及持续性房颤与HCY水平进行相关分析，显示房颤复发睛况与HCY水平呈正相关（r=0．358，P〈0．01）。经多因素回归分析示血浆HCY水平与房颤消融术后复发独立相关（比值比：1．17，95％可信区间1．01～1．36，P=0．04）结论：血浆HCY水平对房颤导管消融复发有预测作用，是房颤导管消融复发独立危险因素。Objective： To explore the relationship between plasma homocysteine （Hcy） level and atrial fibrillation （AF） recurrence in patients after catheter ablation. Methods： A total of 126 AF patients who received catheter ablation were studied including 81 of paroxysmal AF and 45 of persistent AF. Plasma Hcy level was examined by ELISA, and the patients were divided into 3 groups. Normal Hcy group （Hey level at 5-13 μmol/L）, n=57, High Hcy group （Hcy level at 13-18 lamol/L）, n=46 and Very high Hcy group （Hcy〉18μmol/L）, n=23. The AF recurrence at 3, 6 and 12 months after catheter ablation were observed and compared among different groups. Results： ① For paroxysmal AF patients, the AF recurrence rates were higher at all 3 time points in Very high Hcy group, all P〈0.05 and the Hcy levels were similar between Normal and High Hcy groups. ② For persistent AF patients, the Hcy levels were higher at 6 and 12 months in High and Very high Hcy groups than that in Normal Hcy group, P〈0.05. ③ The correlation analysis indicated that Hcy level was positively related to the risk of AF recurrence, multi-regression analysis showed that Hey level was independently related to AF recurrence, （OR=1. 17, 95%CI 1.01-1.36）, P=0.04 after catheter ablation （1=0.358, P〈0.01）. Conclusion： Plasma Hcy level may predict AF recurrence, it is the independent risk factor for AF recurrence in patients who received catheter ablation.

关 键 词：心房颤动 同型半胱氨酸 导管消融 复发 

分 类 号：R445.1[医药卫生—影像医学与核医学]