高敏C反应蛋白对心房颤动患者电复律后再发的预测

目的通过检测患者血清高敏C反应蛋白(hs-CRP)水平,探讨其对非瓣膜性心房颤动(房颤)患者电复律后再发的预测价值。方法非瓣膜性持续性房颤经电复律的患者126例,男性73例,女性53例,平均年龄(64±10)岁,在电复律前,测定hs-CRP,依据hs-CRP水平将患者分为3组,低水平组41例,hs-CRP<2.0 mg/L,中等水平组47例,hs-CRP 2.0~3.0 mg/L,高水平组38例,hs-CRP>3.0 mg/L。随访6个月,复查24 h动态心电图,观察房颤的复发情况。结果3组在年龄、房颤时间、左心房大小、心功能方面比较差异无统计学意义(P>0.05)。6个月随访时,低水平组房颤的复发率7.3%,远低于中等水平组的21.3%和高水平组的36.8%,差异有统计学意义(P<0.001),中等水平组房颤的复发率低于高水平组(P<0.05),Cox回归分析显示,hs-CRP水平与电复律后,房颤再发呈显著正相关(OR=3.22,95%CI:1.58~13.41)。结论非瓣膜性持续性房颤电复律后,hs-CRP水平与房颤的中期再发有关,hs-CRP可以作为房颤电复律后再发的独立预测因子。

Prediction of recurrence of atrial fibrillation after electrical cardioversion by C-reactive protein

Objective To investigate the value of high sensitivity CRP(hs-CRP) level in predicting recurrence of atrial fibrillation(AF) after electrical cardioversion.Methods 126 consecutive patients [73 men,53 females,age(64±10)years] with nonvalvular persistent AF who had undergone successful electrical cardioversion were studied.All patients were divided into 3 groups according to hs-CRP level:low level group(<2.0 mg/L),median level group(2.0～3.0 mg/L),high level group(>3.0 mg/L).Results There were no significant differences in age,the duration of AF,left atrial size and cardiac function.AF recurrence rate in patients of the low level group was significantly lower than that in the other two groups(P<0.001)at 6 months of follow-up,also,that in median level group was lower than that in the high level group(P<0.05).Cox regression analysis indicated that hs-CRP was the independent predictor of recurrence of atrial fibrillation after electrical cardioversion.Conclusion The study indicates that recurrence of nonvalvular atrial fibrillation is correlated with hs-CRP level after electrical cardioversion,also,hs-CRP can be the independent predictor of recurrence of atrial fibrillation after electrical cardioversion.