中性粒细胞百分比/白蛋白比值对阵发性房颤患者射频消融术后复发的预测价值

Prognostic Value of NPAR Ratio in Patients with Paroxysmal Atrial Fibrillation after Radiofrequency Ablation

摘要: 目的：分析中性粒细胞百分比/白蛋白比值(NPAR)对阵发性房颤(PAF)患者射频消融术(RFCA)后复发的预测价值。方法：回顾性纳入2022年7月至2023年7月期间首次接受RFCA治疗的142例PAF患者，术后持续随访1年并根据房颤复发情况把研究人群分为复发组(33例)和未复发组(109例)。比较两组人群的临床资料，应用多因素logistic回归分析PAF患者RFCA术后房颤复发的危险因素，绘制受试者工作特征(ROC)曲线，评价NPAR对PAF患者RFCA术后房颤复发的预测价值。结果：与未复发组相比，复发组人群房颤病程较长、LVEF水平降低、LAD水平升高、白蛋白水平偏低、NPAR水平更高，组间差异具有统计学意义(P < 0.05)；多因素logistic回归分析结果显示，房颤病程延长(OR = 4.792, 95% CI = 1.972~11.645)、LVEF水平降低(OR = 3.607, 95% CI = 1.574~8.265)、LAD水平升高(OR = 2.578, 95% CI = 1.401~4.742)、白蛋白水平降低(OR = 8.117, 95% CI = 1.549~42.530)以及NPAR升高(OR = 6.309, 95% CI = 1.474~27.013)是PAF患者RFCA术后房颤复发的独立危险因素。ROC曲线分析结果显示，NPAR预测PAF患者RFCA术后房颤复发的ROC曲线下面积(AUC)及其95% CI为0.847(95% CI = 0.766~0.927, P < 0.001)，灵敏度和特异度分别为81.80%和80.73%。结论：PAF患者较高的NPAR与RFCA术后房颤复发风险增加独立相关，早期检测NPAR对房颤术后复发具有重要的预测价值。

Abstract: Objective: To evaluate the predictive value of neutrophil percentage/albumin ratio (NPAR) in patients with paroxysmal atrial fibrillation (PAF) after radiofrequency ablation (RFCA). Methods: 142 patients with PAF treated from July 2022 to July 2023 were retrospectively included, all of whom received RFCA. They were followed up for 1 year after surgery and were divided into a relapse group (33 cases) and a non-recurrence group (109 cases) according to the recurrence of atrial fibrillation. Clinical data of the two groups were collected, and the NPAR ratio was calculated. Multivariate logistic regression was used to analyze the risk factors of recurrent atrial fibrillation in PAF patients after RFCA. The receiver operating characteristic (ROC) curve was drawn to analyze the value of the NPAR ratio in predicting atrial fibrillation recurrence in PAF patients after RFCA. Results: The duration of atrial fibrillation in the relapsed group was longer than that in the non-relapsed group, the level of albumin was lower than that in the non-relapsed group, and the ratio of NPAR was higher than that in the non-relapsed group (P < 0.05). The results of multivariate logistic regression analysis showed: The duration of atrial fibrillation was prolonged (OR = 4.792, 95% CI = 1.972~11.645), the albumin level was decreased (OR = 8.117, 95% CI = 1.549~42.530), and the NPAR ratio was increased (OR = 6.309, 95% CI = 1.474~27.013) were risk factors for recurrence of atrial fibrillation after RFCA in PAF patients (P < 0.05). ROC curve results showed that the AUC of NPAR ratio predicting atrial fibrillation recurrence after RFCA in PAF patients was 0.847 (95% CI = 0.766~0.927, P < 0.001), sensitivity was 81.80%, and specificity was 80.73%. Conclusion: There is a close relationship between the NPAR ratio and RFCA recurrence in PAF patients, and the NPAR ratio increases in patients with a higher risk of postoperative recurrence. Early detection of the NPAR ratio has important diagnostic value for postoperative atrial fibrillation recurrence.