HATCH评分、APPLE评分在心房颤动患者射频消融术后复发的预测价值研究  

Predictive value of HATCH scores and APPLE scores to recrudescence of atrial fibrillation in patients with atrial fibrillation after radiofrequency ablation

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(Second 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7期843-846,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：目的探讨HATCH评分、APPLE评分在心房颤动(房颤)患者射频消融术后复发的预测价值。方法选取2018年5月至2020年6月于秦皇岛市第一医院心血管内科行射频消融术治疗的105例房颤患者的临床资料进行回顾性分析,观察手术时间、X线曝光时间、消融成功率及复发率;且根据术后3个月后是否出现持续时间≥30 s的快速性房性心律失常分为复发组(n=36)和未复发组(n=69),分析影响复发的危险因素,评估HATCH评分、APPLE评分及两项联合评估房颤患者术后复发的AUC值、敏感度、特异度。结果105例房颤患者均顺利完成射频消融术,消融成功率为65.71%,复发率为34.29%。复发组与未复发组在性别、年龄、病程、合并高血压、糖尿病、心力衰竭、估算的肾小球滤过率(eGFR)、持续性房颤、左心室大小、左室射血分数(LVEF)、右室前后径、升主动脉内径、肺动脉主干内径、室内隔厚度、左室后壁厚度、主动脉瓣口血流速度、肌酐等资料比较中,差异均无统计学意义(P>0.05);而在左心房大小、E峰、HATCH评分、APPLE评分等比较中,差异具有统计学意义(P<0.05)。二元Logistic回归分析显示,左心房大小、E峰、HATCH评分、APPLE评分是影响手术治疗后复发的独立危险因素(P<0.001)。ROC曲线分析显示,HATCH评分、APPLE评分及两项联合评估房颤患者术后复发的AUC值分别为(0.747、0.807、0.927,P<0.05);敏感度分别为44.40%、69.40%、94.40;特异度分别为91.30%、85.50%、84.10%。结论HATCH评分、APPLE评分预测房颤患者射频消融术后复发具有一定价值,且两项联合有利于提高敏感度,能为识别术后复发提供指导。Objective To discuss the predictive value of HATCH scores and APPLE scores to recrudescence of atrial fibrillation(AF)in AF patients radiofrequency ablation(RFA).Methods The clinical materials were retrospectively analyzed in AF patients(n=105)undergone RFA from Department of Cardiovascular Medicine in the First Hospital of Qinhuangdao City from May 2018 to June 2020.The operation time,X-ray exposure time,RFA success rate and AF recurrent rate were observed.All patients were divided,according to whether they had atrial tachyarrhythmia with duration≥30 s after operation for 3 months or not,into recurrent group(n=36)and nonrecurrent group(n=69).The risk factors of AF recrudescence were analyzed,and AUC,sensitivity and specificity of HATCH scores,APPLE scores and HATCH scores+APPLE scores in predicting AF recrudescence after the operation were reviewed.Results All 105 patients completed RFA successfully,RFA success rate was 65.71%and AF recurrent rate was 34.29%.The differences in sex,age,disease course,complicated hypertension,diabetes and heart failure,estimated glomerular filtration rate(eGFR),persistent atrial fibrillation(PeAF),left ventricular size,left ventricular ejection fraction(LVEF),right ventricular anteroposterior diameter(RVAPD),ascending aortic diameter(AAoD),main pulmonary artery diameter,interventricular septum thickness,left ventricular posterior wall thickness(LVPWT),flow velocity of aortic valve orifice and serum creatinine(SCr)had no statistical significance between 2 groups(P>0.05).The differences in left atrial size,Epeak,HATCH scores and APPLE scores had statistical significance between 2 groups(P<0.05).The results of binary Logistic regression analysis showed that left atrial size,E peak,HATCH scores and APPLE scores were independent risk factors of postoperative AF recrudescence(P<0.001).The results of ROC curve analysis showed that AUC of HATCH scores,APPLE scores and HATCH scores+APPLE scores was,respectively,0.747,0.807 and 0.927(P<0.05),sensitivity was,respectively,44.40%,69.40%and 9

关 键 词：HATCH评分 APPLE评分 射频消融术 心房颤动 复发 

分 类 号：R541.75[医药卫生—心血管疾病]