单核细胞与高密度脂蛋白比值对阵发性房颤射频消融术后复发的影响  

Monocyte count-to-HDL cholesterol ratio with the recurrence of paroxysmal atrial fibrillation after catheter ablation

作　　者：胡晓[1] 张静 周学军[1] 纪元[1] 刘宇[1] 丁志坚[1] 

机构地区：[1]南京医科大学附属常州第二人民医院心血管内科14病区,江苏常州213000 [2]江苏护理职业学院,江苏淮安223001

出　　处：《中国急救医学》2016年第5期406-410,共5页Chinese Journal of Critical Care Medicine

基　　金：江苏省常州市卫生局重大项目（ZD201314）

摘　　要：目的探讨阵发性房颤患者射频消融术前单核细胞与高密度脂蛋白比值（MHR）对术后复发的影响。方法连续收集2011-06～2014—11在南京医科大学附属常州二院行射频消融的98例阵发性房颤患者。房颤复发的空白期为3个月，经过（18．1±5．2）个月的随访，29例（29．6％）患者出现房颤复发。根据术后房颤是否复发分为复发组和未复发组。测定术前、术后1周、术后6个月MHR值。对复发组与未复发组资料做单因素分析，并进行指标相关性分析和多因素非条件Logistic回归分析。结果复发组MHR在术前、术后6个月均高于未复发组（P〈0．05）。对复发组与未复发组做单因素分析显示，术前房颤病程、年龄、白细胞计数（wBc）、单核细胞计数、高密度脂蛋白（HDL）、单核细胞计数与高密度脂蛋白比值（MHR）、超敏-C反应蛋白（hs—CRP）及左房前后径（LAD）之间差异有统计学意义伊〈0．05）。MHR与LAD呈正相关（P〈0．01），Pearson相关系数0.378。行多因素非条件Logistic回归分析示，术前房颤病程[OR 2．631，95％可信区间（CI）1．093．6．335，P=0.0311和LAD（OR 2．591，95％CI 1．130～5．945，P=0．025）是阵发性房颤射频消融后的独立危险因素。结论伴有MHR升高的阵发性房颤患者射频消融后复发率更高，MHR对阵发性房颤射频术后复发有一定的预测价值，但其他因素同样重要。Objective To establish whether there is a relationship between monocyte count-to- HDL cholesterol ratio （MHR） and recurrence of paroxysmal atrial fibrillation （PAF） after catheter ablation. Methods Ninety-eight patients diagnosed with PAF from June 2011 to November 2014 in Changzhou Second Hospital were analyzed. Post-ablation blanking period was observed for three months, at a mean follow-up of （18.1 ±5.2） months, 29 patients （29.6%） patients had recurrence of atrial fibrillation. The MHR values were measured at baseline, one week, and six months after operation. The risk factors were analyzed by the multivariate unconditional logistic regression analysis. Results The MHR at baseline and six months in the patients whose PAF had recurred were higher than those without recurrence （P 〈 0.05）. There were significant differences in PAF history, age, white blood cell （WBC）, monocyte count, HDL cholesterol, MHR, hypersensitive C-reative protein （hs-CRP）, left atrial diameter （LAD）（P 〈 0.05）. MHR was positively related with LAD （P 〈 0.05）. Multivariate unconditional logistic regression analysis showed that PAF history （OR： 2.631, 95%CI： 1.093-6.335, P= 0.031） and LAD （OR： 2.591, 95%CI： 1.130-5.945, P = 0.025） were independent predictors of PAF recurrence after catheter ablation. Conclusion Increased pre-ablation MHR level is associated with a higher recurrence of PAF. MHR has a certain predictive value for postoperative recurrence of PAF but it suggests that other factors are also important.

关 键 词：心房颤动 射频消融 复发 单核细胞 高密度脂蛋白(HDL) 

分 类 号：R446.112[医药卫生—诊断学]