冷冻球囊导管消融术对心房颤动患者凝血系统炎症反应及预后情况影响  

A Controlled Study of the Effects of Cryo-Balloon Catheter Ablation on the Coagulation System Inflammatory Response and Prognosis of Patients with Atrial Fibrillation

作　　者：秦菘[1] 陈静[1] QIN Song;CHEN Jing(The Seventh Division Hospital of Xinjiang Production and Construction Corps,Xinjiang Kuitun 833200,China)

机构地区：[1]新疆生产建设兵团第七师医院,新疆奎屯833200

出　　处：《河北医学》2022年第7期1124-1129,共6页Hebei Medicine

基　　金：新疆维吾尔自治区自然科学基金,(编号:2018D01C022)。

摘　　要：目的:研究冷冻球囊导管消融术对心房颤动患者凝血系统、炎症反应及预后情况的影响。方法:选取2017年7月至2021年11月我院心房颤动患者93例,依据治疗方案不同分为冷冻组(n=47)、射频组(n=46)。射频组行射频消融术,冷冻组行冷冻球囊导管消融术。比较两组手术时间、消融时间、肺静脉隔离(PVI)成功率、并发症及术前、术后1d、3d凝血指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、炎症指标[白细胞介素-6(IL-6)、超敏-C反应蛋白(hs-CRP)、白细胞计数(WBC)]水平、术前、术后6个月、12个月心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、术后6个月、12个月复发率。结果:两组PVI成功率比较,差异无统计学意义(P>0.05);冷冻组手术时间、消融时间短于射频组(P<0.05);与术前比较,术后1d、3d两组APTT水平均降低,但冷冻组高于射频组,血浆FIB、D-D、WBC及血清IL-6、hs-CRP水平均提高,但冷冻组低于射频组(P<0.05);冷冻组并发症发生率6.38%与射频组13.04%比较,差异无统计学意义(P>0.05);术后6个月、12个月两组LVEF水平较术前提高,LVESD、LVEDD水平较术前降低,且冷冻组优于射频组(P<0.05);冷冻组术后12个月复发率19.15%低于射频组39.13%(P<0.05)。结论:冷冻球囊导管消融术治疗心房颤动具有手术便捷、术后心功能改善好、复发率低等优点,且对机体凝血系统影响小,炎症反应轻。Objective:To analyze the effects of cryo-balloon catheter ablation on the coagulation system,inflammation and prognosis of patients with atrial fibrillation.Methods:A total of 93 patients with atrial fibrillation in our hospital from Jul.2017 to Nov.2021 were selected and divided into cryo group(n=47)and RF group(n=46)according to different treatment plans.Radiofrequency ablation was performed in the RF group,and cryo-balloon catheter ablation was performed in the cryo group.The two groups were compared in terms of operative time,ablation time,success rate of pulmonary vein isolation(PVI),complications and preoperative,1 d and 3 d postoperative levels of coagulation parameters[activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)],inflammatory parameters[interleukin-6(IL-6),supersensitive-C-reactive protein(hs-CRP),white blood cell count(WBC)WBC]levels,6 month and 12 months cardiac function parameters preoperative and postoperative[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],and 6-month and 12-month postoperative recurrence rates.Results:The difference between the two groups was not statistically significant when comparing the success rate of PVI(P>0.05);the operative time and ablation time in the cryo group were shorter than those in the RF group(P<0.05);compared with the preoperative period,the APTT level decreased in both groups at 1 d and 3 d postoperatively,but was higher in the cryo group than in the RF group;the plasma FIB,D-D,WBC and serum IL-6 and hs-CRP levels increased,but were lower in the cryo group than in the RF group(P<0.05).The incidence of complications was 6.38% in the cryo group compared with 13.04% in the RF group,and the difference was not statistically significant(P>0.05);the LVEF levels increased and the LVESD and LVEDD levels decreased at 6 and 12 months postoperatively compared with the preoperative levels in both groups,and the cryo group was better than the RF group(P<0.05);the

关 键 词：冷冻球囊导管消融术 心房颤动 凝血系统 炎症反应 预后 

分 类 号：R654.2[医药卫生—外科学]