血小板/淋巴细胞比值及左室射血分数对心房颤动射频消融术后复发的预测价值  

The predictive value of platelet to lymphocyte ratio and left ventricular ejection fraction in the recurrence of atrial fibrillation after radiofrequency ablation

作　　者：陈崇杰 昃峰[1] 段江波[1] 李鼎[1] 王龙[1] 吴寸草[1] 何金山[1] 周旭 杨丹丹 李学斌[1] 张海澄[1] Chen Chongjie;Ze Feng;Duan Jiangbo;Li Ding;Wang long;Wu Cuncao;He Jinshan;Zhou Xu;Yang Dandan;Li Xuebin;Zhang Haicheng(Department of Cardiology,Peking University People's Hospital,Beijing 100044,China.)

机构地区：[1]北京大学人民医院心血管内科,北京100044

出　　处：《中国循证心血管医学杂志》2025年第2期168-174,共7页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家社会科学基金重大项目(18ZDA086-4)。

摘　　要：目的探索血小板/淋巴细胞比值(PLR)及左心室射血分数(LVEF)对心房颤动患者导管射频消融术后复发的预测价值。方法选择2021年9月至2022年11月于北京大学人民医院接受导管射频消融术的158例心房颤动患者,根据术后3~12个月有无复发分为复发组与非复发组。收集患者现病史、既往史、个人史、术前实验室指标及超声心动图指标,采用单因素和多因素Logistic回归分析PLR和LVEF对心房颤动复发的影响,进而采用受试者工作特性(ROC)曲线,评价这两个指标对诊断心房颤动射频消融术后复发的作用,确立诊断界值。分析用PLR和LVEF判断心房颤动复发结果的关联性和一致性(配对χ2检验),根据结果确定联合试验的必要性。结果两组患者基线资料比较,术前左心房内径(LAD)、PLR、LVEF、三酰甘油(TG)组间差异具有统计学意义(P<0.05);通过单因素及多因素Logistic回归分析发现,PLR及LVEF是心房颤动射频消融术后复发的独立危险因素;ROC曲线分析显示,PLR及LVEF预测心房颤动射频消融术后复发的曲线下面积(AUC)分别为0.652及0.581,联合指标预测心房颤动射频消融术后复发的AUC为0.682;通过实测数据分析串联试验和并联试验的灵敏度、特异度,串联试验较单一试验特异度提高。结论术前高PLR和低LVEF可以预测心房颤动射频消融术后复发。根据预测心房颤动射频消融术后复发的临床需求,推荐采用PLR及LVEF串联试验提高诊断效率。Objective To explore the predictive value of platelet to lymphocyte ratio(PLR)and left ventricular ejection fraction(LVEF)for recurrence after catheter radiofrequency ablation in patients with atrial fibrillation(AF).Methods A total of 158 patients with atrial fibrillation who underwent catheter radiofrequency ablation at Peking University People's Hospital from September 2021 to November 2022 were selected.They were divided into a recurrent group and a non recurrent group based on whether there was recurrence within 3~12 months after surgery.Patient’s current medical history,past medical history,personal history,preoperative laboratory indicators,and echocardiographic indicators were collected.Univariate and multivariate logistic regression analyses were used to examine the impact of PLR and LVEF on atrial fibrillation recurrence.Subsequently,receiver operating characteristic(ROC)curves were employed to evaluate the role of these two indicators in diagnosing postoperative recurrence of atrial fibrillation after radiofrequency ablation,and diagnostic thresholds were established.The correlation and consistency of using PLR and LVEF to determine the outcome of atrial fibrillation recurrence were analyzed using the paired chi-square test.Based on the results,the necessity of combined testing was determined.Results Comparison of baseline data between the two groups of patients showed statistically significant differences in preoperative left atrial diameter(LAD),PLR,LVEF,and triglycerides(TG),(P<0.05).Univariate and multivariate logistic regression analyses revealed that PLR and LVEF are independent risk factors for recurrence of atrial fibrillation after radiofrequency ablation.ROC curve analysis demonstrated that the area under the curve(AUC)for PLR and LVEF in predicting postoperative recurrence of atrial fibrillation after radiofrequency ablation were 0.652 and 0.581,respectively,while the AUC for the combined indicators in predicting postoperative recurrence of atrial fibrillation was 0.682.Analysis of the sen

关 键 词：心房颤动 射频消融 复发 血小板/淋巴细胞比值 射血分数 联合试验 

分 类 号：R541.75[医药卫生—心血管疾病]