血清胆红素水平及左房容积指数与心房颤动患者导管射频消融术后冠状动脉事件复发的相关性研究  

Correlation of Serum Bilirubin Level and Left Atrial Volume Index with Coronary Event Recurrence after Catheter Radiofrequency Ablation in Patients with Atrial Fibrillation

作　　者：许萍 马晓峰 曹建东 王红 白丽娟 XU Ping;MA Xiao-feng;CAO Jian-dong;WANG Hong;BAI Li-juan(Department of Cadre Health,Cardiovascular and Cerebrovascular Disease Hospital of Qinghai Province,Xining 810001,China;Department of Ultrasound,Cardiovascular and Cerebrovascular Disease Hospital of Qinghai Province,Xining 810001,China)

机构地区：[1]青海省心脑血管病专科医院干部保健科,西宁810001 [2]青海省心脑血管病专科医院超声科,西宁810001

出　　处：《临床误诊误治》2022年第12期30-34,共5页Clinical Misdiagnosis & Mistherapy

基　　金：青海省医药卫生科技项目(2019063)。

摘　　要：目的探讨血清胆红素水平及左房容积指数(LAVI)与心房颤动患者导管射频消融术(RFCA)后冠状动脉事件复发的相关性。方法选取2020年1月—2022年1月收治的行RFCA治疗的心房颤动(AF)196例,均在术前完善相关辅助检查并行RFCA治疗。比较患者术后6个月的治疗效果,并根据术后1周内是否复发分为复发组和未复发组。比较2组术后1周血清学指标[高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆红素(TBIL)、直接胆红素、间接胆红素(IBIL)]和超声心动图参数[左室收缩末期直径、左室舒张末期直径、左室射血分数、LAVI],并分析血清TBIL、IBIL水平与LAVI的关系,以及血清TBIL、IBIL和LAVI联合检测对AF患者RFCA术后冠状动脉事件复发的预测价值。结果196例中151例(77.04%)治疗成功,53例复发。复发组血清TBIL、IBIL均低于未复发组,LAVI高于未复发组(P<0.01)。血清TBIL、IBIL与LAVI均呈负相关(r=-0.162、-0.306,P<0.05,P<0.01)。血清TBIL、IBIL及LAVI预测AF患者RFCA术后冠状动脉事件复发的曲线下面积(AUC)分别为0.794、0.789、0.742,联合检测可提高预测敏感度,AUC为0.832。结论胆红素及LAVI与AF患者RFCA术后冠状动脉事件复发有关,其中TBIL、IBIL与LAVI呈负相关,临床可以通过以上指标联合检测判断AF患者RFCA术后冠状动脉事件的复发风险。Objective To investigate the correlation of serum bilirubin levels and left atrial volume index(LAVI)with coronary event recurrence after catheter radiofrequency ablation(RFCA)in patients with atrial fibrillation(AF).Methods A total of 196 patients with AF who received RFCA treatment from January 2020 to January 2022 were selected.All of them underwent preoperative adjuvant examination and RFCA treatment.The therapeutic effect of patients at 6 months after surgery was compared,and the patients were divided into recurrence group and non-recurrence group according to the recurrence within 1 week after surgery.The serological parameters[high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total bilirubin(TBIL),direct bilirubin and indirect bilirubin(IBIL)]and echocardiographic parameters[left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left atrial volume index(LAVI)]of the two groups were compared at 1 week after surgery.The relationship between serum TBIL and IBIL levels and LAVI,as well as the predictive value of combined detection of serum TBIL,IBIL and LAVI for postoperative coronary event recurrence in AF patients undergoing RFCA was analyzed.Results Of 196 patients,151 patients(77.04%)were successfully treated,and 53 patients had recurrence.Serum TBIL and IBIL in the recurrence group were lower than those in the non-recurrence group,and LAVI was higher than that in the non-recurrence group(P<0.01).Serum TBIL and IBIL were negatively correlated with LAVI(r=-0.162,-0.306,P<0.05,P<0.01).The area under receiver operating characteristic(ROC)curve(AUC)of serum TBIL,IBIL and LAVI for predicting the recurrence of coronary events after RFCA in AF patients was 0.794,0.789 and 0.742,respectively.Combined detection could improve the prediction sensitivity and the AUC was 0.832.Conclusion Bilirubin and LAVI are associated with the recurrence of coronary events in AF patients after RFCA,among which TBIL and

关 键 词：心房颤动 导管射频消融术 胆红素 左房容积指数 冠状动脉 复发 相关性 

分 类 号：R541.75[医药卫生—心血管疾病]