血清同型半胱氨酸、射血分数及左房容积指数与心房颤动射频消融术后复发的相关性研究  

Correlation between Hcy,ejection fraction,left atrial volume index and AF recurrence after radiofrequency ablation

作　　者：陈伟刚[1] 张守彦[1] 谷云飞[1] 金军[1] 齐玉婕 吴鹏宇 Chen Weigang;Zhang Shouyan;Gu Yunfei;Jin Jun;Qi Yujie;Wu Pengyu(Department of Cardiology,Luoyang Central Hospital,Luoyang,471003,China;不详)

机构地区：[1]洛阳市中心医院心内科,洛阳471003

出　　处：《中国循证心血管医学杂志》2021年第4期421-424,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省科技发展计划项目(202102310041)。

摘　　要：目的探讨心房颤动(房颤,AF)患者血清同型半胱氨酸(Hcy)、左室射血分数(LVEF)及左房容积指数(LAVI)与导管射频消融术(RFCA)后复发的相关性。方法选取2018年1月至2020年1月于洛阳市中心医院心内科收治的120例房颤患者为研究对象,所有患者均行RFCA治疗,术后随访3个月,根据是否AF复发分为两组,复发组(n=31)和无复发组(n=89)。检测所有患者血清Hcy水平,并行超声心动图(UCC)检查;对比两组患者血清Hcy水平和LVEF、LAVI,Pearson相关性分析血清Hcy与LVEF、LAVI的相关性,多因素Logistics回归分析RFCA后AF复发的影响因素;绘制ROC曲线,分析Hcy、LVEF、LAVI对AF患者RFCA后复发的预测价值。结果复发组血清Hcy水平和LAVI明显高于无复发组,LVEF明显小于无复发组(P<0.05);Pearson相关性分析显示,血清Hcy与LVEF呈负相关,与LAVI呈正相关(P<0.05);多因素Logistics回归分析显示,Hcy、LVEF、LAVI为RFCA后AF复发的独立影响因素(P<0.05);ROC曲线显示,Hcy、LVEF、LAVI预测AF患者RFCA后复发的曲线下面积(AUC)和敏感度及特异性分别为0.885、0.677、0.602;0.765、0.968、0.727;0.901、0.935、0.802。结论Hcy、LVEF、LAVI为AF患者RFCA后复发的独立影响因素,早期检测和测量可预测房颤复发,改善患者预后。Objective To investigate the relationship between serum homocysteine(Hcy),left ventricular ejection fraction(LVEF),and left atrial volume index(LAVI)and recurrence after catheter radiofrequency ablation(RFCA)in patients with atrial fibrillation(AF).Methods A total of 120 AF patients who were admitted to the Department of Cardiology at the Central Hospital of Rome from January 2018 to January 2020 were selected as the study subjects,all patients underwent RFCA and were followed up for 3 months postoperatively and divided into 2 groups according to whether AF recurrences occurred,recurrence group(n=31)and no recurrence group(n=89).Serum Hcy levels were measured in all patients,and echocardiography(UCC)was performed in parallel.Serum Hcy levels and LVEF,LAVI were compared between the two groups.Pearson's correlation was used to analyze the correlation between serum Hcy and LVEF,LAVI.Multivariate logistic regression was used to analyze the factors contributing to AF recurrence after RFCA.ROC curves were drawn to analyze the predictive value of Hcy,LVEF,LAVI for AF recurrence after RFCA in these two groups.Results The level of Hcy and Lavi in recurrent group were significantly higher than those in non recurrent group,and LVEF in recurrent group was significantly lower than that in non recurrent group(P<0.05).Pearson correlation analysis showed that serum Hcy was negatively correlated with LVEF and positively correlated with Lavi(P<0.05).Multivariate logistic regression analysis showed that Hcy,LVEF and Lavi were independent factors for AF recurrence after RFCA(P<0.05).ROC curve showed that area under curve(AUC),sensitivity and specificity of Hcy,LVEF and Lavi in predicting recurrence after RFCA were 0.885,0.677,0.602;0.765,0.968,0.727;0.901,0.935,0.802,respectively.Conclusion Hcy,LVEF and Lavi were independent factors of AF recurrence after RFCA.Early detection and measurement can predict AF recurrence and improve the prognosis.

关 键 词：心房颤动 房颤导管消融术 同型半胱氨酸 左室射血分数 左房容积指数 

分 类 号：R541.75[医药卫生—心血管疾病]