非瓣膜性心房颤动患者血清C-反应蛋白变化及其临床意义

目的测定非瓣膜性心房颤动(简称房颤)患者血清C-反应蛋白及外周血白细胞的变化,以探讨炎症机制在非瓣膜性房颤的发生发展中的作用。方法对135例房颤患者(房颤组)和120例非房颤患者(对照组),采用免疫比浊法测定其血清中CRP水平,用库尔特JT血球仪测定外周血白细胞数(WBC)、中性粒细胞百分率(N%)、中性粒细胞绝对值(N)、淋巴细胞百分率(L%)、淋巴细胞绝对值(L)。应用超声心动图诊断左室肥厚(LVH)及左房内径(LAD)。观察CRP及白细胞变化与房颤关系。结果房颤组血中CRP水平显著高于非房颤组(6.41±2.73mg/Lvs3.66±1.18mg/L;P<0.05)。其中房颤合并LVH较不合并LVH组CRP显著增高(7.51±3.32mg/Lvs5.76±2.92mg/L;,P<0.05)。四分位法研究表明房颤组血清CRP水平位于最高四分位者显著多于对照组;房颤组血清CRP水平位于最高四分位者较同组最低四分位者显著增加(P<0.05)。CRP位于最高四分位者LAD较位于最低四分位者显著增加(P<0.05)。两组WBC、N%、N、L%、L无显著性差异。结论慢性炎症反应在非瓣膜性房颤的发生发展中可能起到重要的作用。

The alterations and significances of serum C-reactive protein levels and leukocyte count in patients with atrial fibrillation

Objective To study alterations and significances of serum C-reactive protein(CRP) and leukocyte count in patients with atrial fibrillation(AF). Methods 135 patients with AF(male 86 cases, female 49 cases, average age 68.11±11.26 years) and 120 patients without AF(male 77 cases, female 43 cases, average age 63.28±11.96 years) were examined the levels of CRP in serum by immune colorimetric method. Left atrium diameter (LAD) and left ventricle hypertrophy(LVH) were determined by echocardiography. AF was identified by self-reported history and ECGs. Results The serum CRP in the patients with AF was higher than that in the patients without AF(6.41±5.73 mg/L vs 3.66±1.18 mg/L,P<0.05);In the patients with AF,CRP in the patients with LVH was higher than that in the patients without LVH(7.51±3.32 mg/L vs 5.76±2.95 mg/L, P<0.05).The presence of AF in the highest quartile of CRP group was significantly increased in comparison with the lowest quartile of CRP group. Compared with subjects in the lowest CRP quartile (<2.0 mg/L), subjects in the highest quartile (>6.0 mg/L) had more AF,LVH and enlarged LAD. Conclusion Inflammation may play a role in both the initiation and progression of AF.