左心室射血分数降低的阵发性心房颤动患者冷冻球囊消融术后复发危险因素分析  

Relapse risk factors after frozen balloon ablation in patients with paroxysmal atrial fibrillation with reduced ejection fraction

作　　者：李晓刚[1] 于颖慧 李小伟 张璐[1] 何健 Li Xiaogang;Yu Yinghui;Li Xiaowei;Zhang Lu;He Jian(Department of Cardiovascular Medicine,First Hospital of Qinhuangdao City,Qinhuangdao 066000,China.;不详)

机构地区：[1]秦皇岛市第一医院心血管内科二病区,秦皇岛066000 [2]秦皇岛市第一医院心血管外科,秦皇岛066000

出　　处：《中国循证心血管医学杂志》2023年第2期202-205,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省秦皇岛市科学技术研究与发展计划(202101A117)。

摘　　要：目的回顾性分析左心室射血分数降低的阵发性心房颤动(PAF)患者行冷冻球囊消融术(CBA)后复发危险因素,以期降低术后复发的风险。方法通过收集2017年6月至2019年6月于秦皇岛市第一医院接受CBA且左心室射血分数降低的PAF患者104例的临床资料及随访资料,对CBA术后复发的相关因素进行单因素和多因素分析。结果单因素分析结果显示,患者的体质指数(BMI)(P=0.004)、术后是否规律服用抗心律失常药物(P=0.045)、CHA2DS2-VASc评分(P=0.043)、高血压(P=0.028)、血尿酸水平(P=0.032)、超敏C反应蛋白(hs-CRP)水平(P=0.048)与术后复发相关;多因素Logistics回归分析结果显示BMI(OR=1.365,95%CI:1.072~1.737,P=0.011)、CHA2DS2-VASc评分(OR=2.457,95%CI:1.079~5.597,P=0.032)、高血压(OR=1.652,95%CI:1.036~2.634,P=0.035)、血尿酸(OR=1.335,95%CI:1.053~1.692,P=0.017)、hs-CRP水平(OR=3.380,95%CI:1.213~9.422,P=0.020)是影响术后心房颤动复发的独立危险因素。结论患者BMI较大、CHA2DS2-VASc评分较高、伴有高血压、高尿酸血症、hs-CRP升高是影响射血分数降低的PAF术后复发的独立危险因素。Objective To analyze retrospectively the relapse risk factors after cryoballoon catheter ablation(CBA)in patients with paroxysmal atrial fibrillation with reduced ejection fraction(PAFrEF),and to hope reduce the hazard of PAFrEF relapse risk after the operation.Methods The clinical materials and follow-up materials of PAFrEF patients received CBA(n=104)were collected in the First Hospital of Qinhuangdao City from June 2017 to June 2019.The factors related to PAFrEF relapse risk after CBA were given single-factor analysis and multi�factor analysis.Results The results of single-factor analysis showed that body mass index(BMI,P=0.004),whether or not regularly taking antiarrhythmic drugs after CBA(P=0.045),CHA2DS2-VASc scores(P=0.043),hypertension(P=0.028)and levels of blood uric acid(BUA,P=0.032)and high sensitivity C-reactive protein(hs-CRP,P=0.048)were correlated to PAFrEF relapse after CBA.The results of multi-factor Logistics regression analysis showed that BMI(OR=1.365,95%CI:1.072~1.737,P=0.011),CHA2DS2-VASc scores(OR=2.457,95%CI:1.079~5.597,P=0.032),hypertension(OR=1.652,95%CI:1.036~2.634,P=0.035),BUA(OR=1.335,95%CI:1.053~1.692,P=0.017),and hs-CRP(OR=3.380,95%CI:1.213~9.422,P=0.020)were independent risk factors of influencing PAFrEF relapse.Conclusion The higher BMI and CHA2DS2-VASc scores,hypertension,hyperuricacidemia and increased hs-CRP are independent risk factors of influencing PAFrEF relapse.

关 键 词：心房颤动 冷冻球囊 导管消融 心力衰竭 射血分数 复发 

分 类 号：R541.75[医药卫生—心血管疾病]