电复律前后超敏C-反应蛋白浓度与远期心房颤动复发的关系

目的探讨电复律前、后高敏C反应蛋白（highsensitivityreactivepmtein，hs-CRP）浓度与远期心房颤动（房颤）复发之间的关系。方法选择确诊为持续性房颤而进行电复律治疗有效的患者102例为研究对象。复律前及复律后第1、3、7及28天检测所有患者hs-CRP浓度、12导联心电图及动态心电网，随访时间为24个月。根据房颤是否复发分为两组：窦律维持组（67例）及房颤复发组（35例），并对两组相关资料进行比较分析。结果两组除心房内径比较差异有统计学意义（P〈0．05）外，其他基础临床资料比较，差异无统计学意义（P〉0．05）。复律前房颤复发组的hs-CRP浓度显著高于窦律维持组，差异有统计学意义[（16．1±5．4）mg／L vs（11．2±4．2）mg／L，P〈0．05]。复律后第1天两组的hs-CRP浓度下降幅度比较，差异无统计学意义（P〉0．05）。复律后第3、7、28天，窦律维持组hs-CRP浓度与复律前相比显著性下降，差异有统计学意义（P〈0．05）；房颤复发组有下降，但差异无统计学意义（P〉0．05）。Cox多元回归分析结果显示，左心房内径（OR=1．11，95％CI：1．01～1．18）、基线hs-CRP浓度（OR=1．39，95％CI：1．20～3．40）及复律后第3天的hs-CRP浓度（OR=1．13，95％CI：0．92～2．36）与房颤复发呈正相关。结论复律前、后hs-CRP浓度对远期房颤复发均具有预测价值。

Association between high-sensitivity C-reactive protein levels and long-term atrial fibrillation recurrence pre-and post-electrical cardioversion

Objectives To investigate the association between high-sensitivity C-reactive protein （hs-CIRP） levels and long-term risk of atrial fibrillation （AF） recurrence pre- and post- electrical eardioversion （CV）. Methods Totally 102 patients with persistent AF undergone CV and recovered were enrolled. Hs-CRP levels were examined in all patients, and hlood samples were taken before CV as well as on the 1^st, 3^nd, 7^th and 28^th day after CV. AF relapse was determined by 24-hour ambulatory eleetroeardiogram （ECG） and standard 12-lead ECG during 24-months of follow-up period. We further divided the patients into two groups according to their rhythm at the end of the follow-up period ： 67 patients with sinus rhythm in sinus rhythm group; 35 patients with AF in AF relapse group. Data of the two groups were compared and analyzed. Results Except left atrial diameter （P〈0.05）, there were no significant differences in other baseline characteristics between the two groups （P〉0.05）. Hs-CRP levels were obviously higher in patients with AF relapse than in those with sinus rhythm before CV [ （16.1±5.4） mg/L vs. （11.2±4.2） mg/L,P〈0.05 ]. At the 1^st day after CV, hs-CRP levels in both groups had declined, but there was no significant difference （P〉0.05）. At the 3^nd,7^th and 28^th day after CV, hs-CRP levels in sinus rhythm group significantly decreased compared with those before CV （P〈 0.05）, whereas hs-CRP levels decreased but not remarkably in AF relapse group （P〉0.05）. Cox multivariate analysis indicated that AF relapse positively correlated to left atrial diameter （OR = 1.11, 95%CI： 1.01-1.18）, basal hs-CRP level （OR=1.39, 95%CI： 1.20-3.40） and hs-CRPlevelon the 3^rd day afterCV （OR=1.13, 95%CI： 0.92-2.36）. Conclusions Hs-CRP levels have predictive value for long-term risk of AF relapse both before and after CV.