血清N末端脑钠肽前体、胱抑素C和白细胞介素-17对老年持续性心房颤动患者射频导管消融术后复发的预测价值  

The value of serum N-terminal pro-brain natriuretic peptide,cystatin C and interleukin-17 in predicting relapse after radiofrequency catheter ablation in elderly patients with persistent atrial fibrillation

作　　者：张岳 黄敏 常建梅 Zhang Yue;Huang Min;Chang Jianmei(Department of Cardiovascular Medicine,Shanghai Pudong New Area People's Hospital,Shanghai 200120,China;Department of General Practice,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]上海市浦东新区人民医院心血管内科,上海200120 [2]新疆医科大学第五附属医院全科医学科,乌鲁木齐830000

出　　处：《中国医师进修杂志》2024年第7期611-617,共7页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨老年持续性心房颤动患者N末端脑钠肽前体(NT-proBNP)、胱抑素C(CysC)、白细胞介素-17(IL-17)对射频导管消融(RFCA)术后复发的预测价值。方法回顾性分析上海市浦东新区人民医院2020年1月至2021年12月69例行RFCA治疗的老年持续性心房颤动患者(心房颤动组)的临床资料。另外选取同期69例健康体检者作为健康对照组。检测两组血清NT-proBNP、CysC和IL-17水平。记录RFCA术后复发情况。采用多因素Logistic回归分析影响老年持续性心房颤动患者RFCA术后复发的独立危险因素。绘制受试者工作特征(ROC)曲线,评价NT-proBNP、CysC和IL-17预测老年持续性心房颤动患者RFCA术后复发的价值。结果心房颤动组术前和术后7 d血清NT-proBNP、CysC和IL-17明显高于健康对照组[(789.41±89.22)和(358.96±50.24)ng/L比(114.38±32.56)ng/L、(1.42±0.30)和(1.20±0.21)mg/L比(0.98±0.17)mg/L、(12.48±3.21)和(9.83±2.58)ng/L比(7.85±2.13)ng/L],差异有统计学意义(P<0.05);术后1和3个月与对照组比较差异无统计学意义(P>0.05)。心房颤动组术后7 d、1个月和3个月血清NT-proBNP、CysC和IL-17明显低于术前,差异有统计学意义(P<0.05)。69例患者随访1年,复发20例,未复发49例。复发与未复发患者术前和术后7 d血清NT-proBNP、CysC和IL-17比较差异无统计学意义(P>0.05);复发患者术后1和3个月血清NT-proBNP、CysC和IL-17明显高于未复发患者[术后1个月:(132.49±32.84)ng/L比(115.56±27.61)ng/L、(1.10±0.15)mg/L比(0.99±0.12)mg/L和(8.59±1.76)ng/L比(7.65±1.58)ng/L;术后3个月:(140.37±32.83)ng/L比(119.90±25.44)ng/L、(1.17±0.20)mg/L比(1.02±0.15)mg/L和(9.12±2.31)ng/L比(7.74±1.80)ng/L],差异有统计学意义(P<0.05或<0.01)。多因素Logistic回归分析结果显示,术后1和3个月血清NT-proBNP、CysC和IL-17是影响老年持续性心房颤动患者RFCA术后复发的独立危险因素(P<0.01)。ROC曲线分析结果显示,术后3个月血清NT-proBNP、CysC、IL-17ObjectiveTo investigate the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP),cystatin C(CysC)and interleukin-17(IL-17)in relapse after radiofrequency catheter ablation(RFCA)in elderly patients with persistent atrial fibrillation.MethodsThe clinical data of 69 elderly patients with persistent atrial fibrillation underwent RFCA(atrial fibrillation group)in Shanghai Pudong New Area People′s Hospital from January 2020 to December 2021 were retrospectively analyzed.Additionally,69 healthy subjects underwent physical examinations during the same period were selected as the healthy control group.The levels of serum NT-proBNP,CysC and IL-17 were detected.The relapse after RFCA was recorded.Multivariate Logistic regression was used to analyze the independent risk factors of relapse after RFCA in elderly patients with persistent atrial fibrillation.The values of NT-proBNP,CysC and IL-17 in predicting the relapse after RFCA in elderly patients with persistent atrial fibrillation were evaluated by the receiver operating characteristics(ROC)curve.ResultsThe serum NT-proBNP,CysC and IL-17 before operation and 7 d after operation in atrial fibrillation group were significantly higher than those in healthy control group:(789.41±89.22)and(358.96±50.24)ng/L vs.(114.38±32.56)ng/L,(1.42±0.30)and(1.20±0.21)mg/L vs.(0.98±0.17)mg/L,(12.48±3.21)and(9.83±2.58)ng/L vs.(7.85±2.13)ng/L,and there were statistical differences(P<0.05);compared with healthy control group,there were no statistical difference in the indexes 1 and 3 months after operation(P>0.05).The serum NT-proBNP,CysC and IL-177 d,and 1,3 month after operation in atrial fibrillation group were significantly lower than those before operation,and there were statistical differences(P<0.05).The 69 patients were followed up for 1 year,with 20 cases experiencing relapse and 49 cases not experiencing relapse.There were no statistical differences in the serum NT-proBNP,CysC and IL-17 before operation and 7 d after operation between relapse patients and

关 键 词：心房颤动 导管消融术 利钠肽 脑 半胱氨酸蛋白酶抑制物C 白细胞介素17 

分 类 号：R541.75[医药卫生—心血管疾病]