非糖尿病阵发性房颤患者甘油三酯-葡萄糖指数与射频导管消融术后复发的关系  

Relationship between the pre-ablation triglyceride-glucose index and recurrence after radiofrequency catheter ablation in nondiabetic patients with paroxysmal atrial fibrillation

作　　者：王庆亚 何洪涛 王涛[2] 惠杰[2] 张俊[1] WANG Qingya;HE Hongtao;WANG Tao;HUI Jie;ZHANG Jun(Department of Cardiology,the Affiliated Suzhou Hospital of Nanjing Medical University(Suzhou Municipal Hospital),Suzhou 215008,China)

机构地区：[1]南京医科大学附属苏州医院(苏州市立医院)心内科,215008 [2]苏州大学附属第一医院心内科

出　　处：《浙江医学》2025年第2期126-131,138,共7页Zhejiang Medical Journal

基　　金：国家重点研发计划“常见多发病防治研究”重点专项(2021YFC2500600、2021YFC2500602)。

摘　　要：目的探讨术前甘油三酯(TG)-葡萄糖(TyG)指数预测非糖尿病阵发性房颤(PAF)患者射频导管消融术(RFCA)后复发的价值。方法回顾性分析2019年1月至2020年12月在苏州大学附属第一医院心内科行首次RFCA治疗的非糖尿病PAF患者210例。TyG指数=ln[空腹TG(mmol/L)×空腹血糖(mmol/L)/2]。术后随访12个月,记录复发情况,比较复发组与未复发组患者的基线资料。采用Cochran-Armitage趋势检验对不同TyG指数四分位数PAF患者的复发率进行分析,采用多因素Cox回归分析RFCA后PAF复发的危险因素,绘制ROC曲线分析TyG指数对PAF患者RFCA术后复发的预测效能。结果PAF复发38例(18.1%),未复发153例(81.9%)。复发组的TyG指数显著高于未复发组[(8.98±0.62)比(8.52±0.39),P<0.001]。TyG指数第1~4四分位数的复发率分别为7.7%、11.3%、20.8%、32.7%(P_(趋势)<0.001)。多因素Cox回归分析显示:TyG指数、左心房内径及二尖瓣血流E峰速度与二尖瓣环处侧壁和间隔舒张早期速度的平均值e'的比值是RFCA后PAF复发的独立危险因素(均P<0.05)。TyG指数预测术后PAF复发的最佳截断值是8.735,灵敏度为0.711、特异度为0.721,AUC为0.727(95%CI:0.628~0.825,P<0.001)。结论术前升高的TyG指数与较高的PAF复发风险相关,可独立预测RFCA后PAF的复发。Objective To investigate the value of pre-ablation triglyceride-glucose(TyG)index in predicting recurrence after radiofrequency catheter ablation(RFCA)in non-diabetic patients with paroxysmal atrial fibrillation(PAF).Methods The clinical data of 210 non-diabetic patients with PAF who underwent the initial RFCA in the Department of Cardiology,the First Affiliated Hospital of Soochow University from January 2019 to December 2020 were retrospectively analyzed,which included 116 males and 94 females.The TyG index was calculated using the following equation:ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].The recurrence during 12 months of postoperative follow-up was recorded,and the baseline data were compared between patients in the recurrence and non-recurrence groups.The Cochran-Armitage trend test was used to analyze the recurrence rate of PAF patients with different TyG index quartiles.Multivariate Cox regression analysis was used to analyze risk factors for recurrence after RFCA to establish the prediction model.Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the prediction efficiency of TyG index for recurrence of PAF patients after RFCA.Results Thirty-eight patients(18.1%)experienced AF recurrence,and 153 patients(81.9%)did not.The baseline TyG index levels of patients with recurrent AF were significantly higher than those without AF recurrence[(8.98±0.62)vs.(8.52±0.39),P<0.001].The incidence of recurrence across quartiles 1-4 of TyG index was 7.7%,11.3%,20.8%and 32.7%,respectively(P_(trend)<0.001).Multivariate Cox regression analysis showed that TyG index,left atrial diameter and average E/e'were independent risk factors for postoperative recurrence of PAF(all P<0.05).The optimal cut-off value of TyG index for predicting PAF recurrence was 8.735 with a specificity of 0.721 and a sensitivity of 0.711.Moreover,the AUC was 0.727(95%CI:0.628-0.825,P<0.001).Conclusion Elevated pre-ablation TyG index levels are related to a higher risk of PAF recurre

关 键 词：心房颤动 甘油三酯-葡萄糖指数 复发 射频导管消融术 

分 类 号：R541.75[医药卫生—心血管疾病]