持续性房颤患者首次射频消融术后复发风险相关因素分析

Analysis of Relevant Risk Factors for Recurrence after First Radiofrequency Ablation in Patients with Persistent Atrial Fibrillation

摘要: 目的：分析持续性心房颤动(Persistent atrial fibrillation, PAF)患者首次射频消融术后房颤复发的影响因素，为临床提供参考依据。方法：选取60名于2018-07至2019-07于青岛大学附属医院住院行射频消融术的PAF患者。根据患者1年内是否复发分为复发组(n = 30)、非复发组(n = 30)。比较两组患者临床资料，分析持续房颤患者射频消融术后复发的影响因素，采用logistic回归分析确定PAF患者射频术后复发的独立危险因素。结果：复发组的病程、术前左心房内径(left atrial diameter, LAD)、N端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)、白蛋白、术后P波离散度、早期复发均显著高于未复发组，复发组的高密度脂蛋白显著低于未复发组，差异有统计学意义(P < 0.05)。logistic回归分析显示，病程、术前LAD、术后P波离散度共三个指标是影响PAF患者射频消融术后复发的独立危险因素(OR > 1)。结论：病程、术前左心房内径、术后P波离散度可在一定程度上评估PAF患者射频消融术后复发风险。

Abstract: Objective: To analyse Persistent atrial fibrillation (PAF) in patients with the influence factors of atrial fibrillation recurrence after radiofrequency ablation for the first time. Methods: 60 PAF patients who underwent radiofrequency ablation in The Affiliated Hospital of Qingdao University from 2018-07 to 2019-07 were selected. Patients were divided into recurrent group (n = 30) and non-recurrent group (n = 30) according to whether they had recurred within 1 year. The clinical data of the two groups were compared to analyze the factors influencing the recurrence of patients with continuous atrial fibrillation after radiofrequency ablation. Results: Recurrence group of course, left atrium diameter (LAD), N-terminal pro-brain natriuretic peptide (NT-proBNP), albumin, P-wave dispersion (PWD), early recurrence rate were significantly higher than non-recur- rence group, the difference was statistically significant (P < 0.05), recurrence group of high-density lipoprotein cholesterol (HDL-c) significantly below non-recurrence group, the difference was statistically significant (P < 0.05). Logistic regression analysis showed that there was a significant positive correlation between disease course, LAD and P-wave dispersion and recurrence (P < 0.05), and they were independent risk factors for recurrence (OR > 1). Conclusion: The course of disease, preoperative left atrial diameter, and postoperative P-wave dispersion can be used to evaluate the possibility of recurrence in patients with PAF after radiofrequency ablation.