EB病毒IgG抗体在预测心房颤动发生及射频消融术后复发中的作用  

The effective of anti-Epstein-Barr virus IgG antibody in predicting the occurrence of atrial fibrillation and post-ablation arrhythmia recurrence

作　　者：井然[1] 刘少伟[1] 夏时俊 刘念[1] 阮燕菲[1] 蒋晨曦[1] 桑才华[1] 汤日波[1] 龙德勇[1] 喻荣辉[1] 白融[1] 杜昕[1] 董建增[1] 马长生[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心内科,100029

出　　处：《心肺血管病杂志》2016年第9期681-685,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：科技部国际合作项目(2013FB30310);国家自然科学基金(81227001);北京市医院管理局临床医学发展专项经费资助(ZYLX201302)

摘　　要：目的：观察心房颤动患者与窦性心律者,心房颤动射频消融术后心房颤动复发及未复发患者中,血清中EB病毒衣壳抗原Ig G抗体（EBV-VCA Ig G抗体）水平,以评估其在预测心房颤动发生及射频消融术后复发的作用。方法：连续入选中国心房颤动注册研究（CAFR）中孤立性心房颤动患者103例,并将流行病调查研究中4 209窦性心律者作为对照组对象来源,经匹配后分别为48例进行分析,比较两组临床特点及EBV-VCA Ig G抗体水平;整体孤立性心房颤动患者与匹配后心房颤动患者根据射频消融术后是否复发分别分为两组,比较两组基线资料及EBV-VCA Ig G抗体水平。结果：比较发现心房颤动组患者组EBV-VCA Ig G抗体较对照组高[（75.91±14.92）vs.（51.08±11.89）μg/m L,P〈0.001],经Logistic回归分析提示EBV-VCA Ig G抗体水平与心房颤动发生存在相关性（OR=1.140,95%CI：1.078-1.205,P〈0.001）;当EBV-VCA Ig G抗体截断值为68.35μg/m L时的预测敏感度为77.1%,特异度为99.0%（95%CI：0.835-0.965,P〈0.001）。但经多因素Cox回归分析未发现EBV-VCA Ig G抗体水平为心房颤动射频消融术后复发的独立危险因素。结论：本研究证实EBV-VCA Ig G抗体水平可能参与心房颤动的发生机制,且对心房颤动的发病具有较好的预测价值。Objective：To evaluate the role of anti-Epstein-Barr virus IgG antibody in predicting the occurrence of atrial fibrillation （AF） and post-ablation arrhythmia recurrence by observing the plasma level of Anti-EBV-VCA IgG. Methods： 103 consecutively recruited lone AF patients enrolled were identified from the CAFR （Chinese Atrial Fibrillation Registry） registry, and 4,209 sinus rhythm person from epidemiology investigation were used as control group source, and then 48 matching pairs from AF group and control group were used for further analysis. Patients＇ baseline data and the plasma levels of Anti-EBV-VCA IgG were analyzed. The overall AF patients and matched AF patients were derived as AF recurrence and AF non-recurrence respec- tively, clinical characteristics and the plasma levels of Anti-EBV-VCA IgG were analyzed. Logistic regression was used to analyze the risk factors associated with AF occurrence, and the predictive power was evaluated by receiver operating characteristic （ROC） curve. Risk factors associated with post-ablation recurrence were analyzed by Cox regression. Results ： The plasma level of Anti-EBV-VCA IgG in AF group was higher than in control group [ （75.91 ± 14. 92） vs. （51.08 ± 11.89） μg/mL, P 〈0. 0011- Logistic regression indicated that the plasma level of Anti-EBV-VCA IgG was related fo the AF occurrence （ OR = 1. 140, 95% CI： 1. 078 - 1. 205）. The cut-off value of Anti-EBV-VCA IgG at 68.35 wg/mL predicted AF occurrence with sensitivity of 77. 1% and specificity of 99.0% （95% CI：0. 835 - 0. 965, P 〈 0. 001 ）. Cox regression demonstrated the Anti-EBV- VCA IgG was not an independent risk factor of post-ablation AF recurrence. Conclusion： Our study indicated that the plasma level of Anti-EBVVCA IgG might be associated with AF development, and was with good value in predicting AF occurrence.

关 键 词：心房颤动 EB病毒衣壳抗原IgG抗体 射频消融术 复发 

分 类 号：R54[医药卫生—心血管疾病]