TyG指数对合并非酒精性脂肪肝的持续性心房颤动患者导管消融术后房颤复发的预测价值  

Value of the TyG index for predicting recurrence after catheter ablation in persistent atrial fibrillation patients combined with non-alcoholic fatty liver disease

作　　者：祁珊珊 梁琦[2] 肖懿慧 白玲[2] 余航 QI Shanshan;LIANG Qi;XIAO Yihui;BAI Ling;YU Hang(Department of Health Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Cardiology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院健康医学科,陕西西安710061 [2]西安交通大学第一附属医院心血管内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2024年第6期954-959,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.82000414)。

摘　　要：目的 探讨甘油三酯葡萄糖(TyG)指数对合并非酒精性脂肪肝的持续性心房颤动患者导管消融术后房颤复发的预测价值。方法 本研究是一项单中心、回顾性、队列研究,回顾性收集了2021年1月至2022年12月于西安交通大学第一附属医院就诊的既往或住院期间行导管消融的合并非酒精性脂肪肝的持续性心房颤动患者的资料,根据术后1年内房颤是否复发分为复发组和未复发组。收集患者一般临床资料和相关实验室检查并计算术前TyG指数。通过单因素及多因素COX比例风险回归模型分析该类患者术后房颤复发的危险因素。通过受试者工作特征(ROC)曲线分析TyG指数预测房颤复发的价值。结果 共纳入167例患者,男103例,女64例。随访时间(12±1.3)个月,52例患者房颤复发,115例未复发。与未复发组相比,复发TyG指数较高(9.62±0.96 vs. 8.26±0.46,P<0.05)。多因素COX回归分析结果显示,术前TyG指数(1.35,95%CI:1.10~1.60,P<0.05)、术后心电图的P波离散度(HR=1.51,95%CI:1.32~1.70,P<0.001)是合并非酒精性脂肪肝的持续性心房颤动导管消融术后房颤复发的危险因素。ROC曲线分析结果显示,TyG指数预测该类患者术后房颤复发的曲线下面积(AUC)为0.846(95%CI:0.773~0.919,P<0.001)。结论 TyG指数是预测合并非酒精性脂肪肝的持续性心房颤动患者导管消融术后房颤复发的有效指标。Objective To explore the value of the TyG index for predicting postoperative recurrence in persistent atrial fibrillation(AF)patients combined with on-alcoholic fatty liver disease(NAFLD)undergoing catheter ablation.Methods This study was a single-center,retrospective,cohort study.Clinical data of patients who underwent catheter ablation during hospitalization or outpatient visits at The First Affiliated Hospital of Xi’an Jiaotong University from January 2021 to December 2022 were retrospectively collected.The patients were divided into recurrence and non-recurrence groups based on whether AF recurred within 1 year after the procedure.General clinical data and relevant laboratory test results were collected,and the preoperative TyG index was calculated.The risk factors for AF recurrence after catheter ablation in these patients were analyzed using univariate and multivariate COX proportional hazards regression models.The value of the TyG index for predicting AF recurrence was assessed using receiver operating characteristic(ROC)curve analysis.Results We recruited 167 patients,among whom 103 were males and 64 were females.The mean follow-up time was 12±1.3 months,with 52 cases of AF recurrence and 115 ones of non-recurrence.Compared with the non-recurrence group,the TyG index was higher in the recurrence group(9.62±0.96 vs.8.26±0.46,P<0.05).Multivariate COX regression analysis showed that the preoperative TyG index(HR=1.35,95%CI:1.10-1.60,P<0.05)and postoperative electrocardiogram P-wave dispersion(HR=1.51,95%CI:1.32-1.70,P<0.001)were risk factors for AF recurrence after catheter ablation in persistent AF patients with NAFLD.The ROC curve analysis showed that the area under the curve(AUC)for the TyG index in predicting AF recurrence after catheter ablation in these patients was 0.846(95%CI:0.773-0.919,P<0.001).Conclusion The TyG index is an effective indicator for predicting atrial fibrillation recurrence after catheter ablation in persistent AF patients combined with NAFLD.

关 键 词：心房颤动 非酒精性脂肪肝 导管消融 甘油三酯葡萄糖指数(TyG指数) 

分 类 号：R541.4[医药卫生—心血管疾病]