心房颤动患者血浆髓过氧化物酶水平与射频消融术后复发的相关性

目的探讨心房颤动患者血浆髓过氧化物酶(MPO)水平与射频消融术(RFCA)后复发的相关性。方法选择2017年1月至2018年6月在该院初次接受RFCA治疗的心房颤动患者82例,根据术后3~12个月是否复发分为复发组(n=30)、未复发组(n=52)。比较两组患者基本临床资料,以及术前血脂、C反应蛋白(CRP)、同型半胱氨酸(HCY)、MPO等实验室指标,分析血浆MPO与术后复发的相关性。结果与未复发组比较,复发组患者持续性心房颤动比例、病程、左心房内径(LAD)、HCY、CRP、MPO水平均明显升高,高密度脂蛋白胆固醇(HDL-C)水平明显下降,差异有统计学意义(P<0.05);与高MPO组比较,低MPO组随访6、12个月时术后复发率均明显降低,差异有统计学意义(P<0.05);多因素logistic回归分析显示,阵发性心房颤动、病程、LAD、HCY、MPO均是RFCA术后复发的独立危险因素(P<0.05)。结论心房颤动患者术前血浆MPO水平与RFCA术后复发密切相关,可作为RFCA患者术后复发的独立评估指标之一。

Correlation between plasma myeloperoxidase levels and recurrence after radiofrequency ablation in patients with atrial fibrillation

Objective To explore the correlation between plasma myeloperoxidase(MPO)levels and recurrence after radiofrequency ablation(RFCA)in patients with atrial fibrillation.Methods Totally 82 patients with atrial fibrillation who were initially treated with RFCA in our hospital from January 2017 to June 2018 were selected and divided into the recurrence group(n=30)and the non-recurrence group(n=52)according to whether recurrence or not at 3-12 months after operation.Basic clinical data,preoperative serum lipids,CRP,HCY,MPO and other laboratory indicators were compared between the two groups to analyze the correlation between plasma MPO and postoperative recurrence.Results Compared with the non-recurrence group,the proportion of persistent atrial fibrillation,course of disease,LAD,HCY,CRP and MPO levels in the recurrence group were significantly increased,while the HDL-C level was significantly decreased(P<0.05).Compared with the high MPO group,the postoperative recurrence rate of the low MPO group was significantly reduced after 6 and 12 months following up(P<0.05).Multi-factor logistic regression analysis showed that paroxysmal atrial fibrillation,course of disease,LAD,HCY and MPO were all independent risk factors for RFCA recurrence after surgery(P<0.05).Conclusion Preoperative plasma MPO level in patients with atrial fibrillation is closely related to RFCA postoperative recurrence,which can be used as an independent evaluation index of RFCA postoperative recurrence.