摘要目的 探讨外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)和超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平对阵发性心房颤动患者射频消融术后复发的影响.方法 收集我院2011年5月至2015年10月收治的行射频消融术治疗的阵发性心房颤动患者89例,按术后复发情况分为复发组和未复发组.观察患者术前NLR和hs-CRP 水平,分析NLR和hs-CRP的相关性,采用Logistic回归分析法分析术后心房颤动复发的危险因素.结果 术后随访1年,共复发27例,复发率为30. 3%(27/89),复发组为27例,未复发组为62例.复发组和未复发组患者术前病程分别为(7. 6 ±3. 4)年与(5. 3±2. 5)年,左心房前后径(left atrium anterior and posterior diameter,LAD)分别为(39. 09±3. 27) mm与(35. 91±3. 95) mm, NLR分别为(3. 69 ± 0. 67)与(2. 58 ± 0. 40),hs-CRP 分别为(5. 20±2. 45) mg/L与(3. 09±1. 70) mg/L,两组比较差异均有统计学意义(P值分别为0. 001、0. 002、0. 004、0. 001). Pearson相关性分析表明,NLR和hs-CRP呈正相关(r＝0. 58,P＜0. 01). Logistic回归分析结果表明,NLR、hs-CRP、LAD是阵发性心房颤动消融术后复发的危险因素[OR(95%CI)值分别为2. 071(1. 689～3. 301)、1. 760(1. 096～4. 286)、1. 943(1. 025～3. 607),P值分别为0. 019、0. 030、0. 035].结论 NLR和hs-CRP水平与射频消融术患者心房颤动复发有关. NLR值及血清hs-CRP升高均为射频消融术后心房颤动复发的危险因素,可作为射频消融术后心房颤动复发的独立预测因素.

abstractsObjective To discuss the efficacy of NLR and hs-CRP levels on recurrence in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation. Methods Eighty-nine cases of paroxysmal atrial fibrillation treated by radiofrequency ablation in Chaoyang Central Hospital from May 2011 to October 2015 were selected and were divided into the recurrence group and non-recurrence group according to the recurrence. The preoperative NLR and hs-CRP levels were observed,and the correlation between NLR and hs-CRP was analyzed. Logistic regression analysis was used to analyze the risk factors of postoperative recurrence of atrial fibrillation. Results 27 cases were recurred after 1 year follow-up,the recurrence rate was 30. 3%( 27/89) . 27 cases in the recurrence group, 62 cases in the non-recurrence group. The disease duration of the recurrence group and the non-recurrence group were (7. 6±3. 4)years and (5. 3±2. 5) years respectively. The left atrial diameter (LAD) were (39. 09±3. 27) mm and (35. 91±3. 95) mm,NLR were(3. 69±0. 67) and (2. 58±0. 40),hs-CRP were (5. 20±2. 45) mg/L and (3. 09±1. 70) mg/L respectively in the two groups,the differences were statistically significant between the two groups (P＝0.001,0.002,0.004,0.001).Pearson correlation analysis showed that there was a positive correlation between NLR and hs-CRP (r＝0. 58,P＜0. 01). Logistic regression analysis showed that NLR,hs-CRP,LAD were risk factors of recurrence (OR(95%CI):2. 071( 1. 689～ 3. 301 ), 1. 760 ( 1. 096～ 4. 286 ), 1. 943 ( 1. 025～ 3. 607 )) ( P ＝ 0. 019, 0. 030, 0. 035). Conclusion The levels of NLR and hs-CRP are associated with the recurrence of atrial fibrillation in patients with radiofrequency ablationts. NLR value and serum hs-CRP increased are the risk factors of recurrent atrial fibrillation after radiofrequency catheter ablation,which can be used as independent predictors of atrial fibrillation recurrence after radiofrequency ablation.