摘要
目的探讨心房颤动(AF)患者射频消融术(RFCA)前血清白细胞介素-18(IL-18)、脂联素(APN)水平与术后复发的关系。方法前瞻性研究,选择2020年3月至2022年6月郑州大学第一附属医院收治的96例AF患者为研究对象。患者均符合RFCA适应证,并接受RFCA治疗,术后接受为期6个月的随访,随访期间重点观察患者复发情况,将其分为复发组及未复发组。在患者入院时统计一般资料,并检测相关实验室指标,重点分析RFCA术前血清IL-18、APN与患者术后复发的关系。结果96例AF患者RFCA术后复发28例,复发率为29.17%。复发组合并高血压、冠心病占比高于未复发组,入院时左心房前后径(LAD)、血清IL-18、内脂素高于未复发组,入院时血清APN低于未复发组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,AF患者入院时LAD、血清IL-18高表达是RFCA术后复发危险因素(OR>1,P<0.05),入院时血清APN高表达是复发的保护因素(OR<1,P<0.05)。限制性立方样条分析结果显示,AF患者RFCA术后复发与入院时血清IL-18呈线性剂量反应关系,呈正相关(P<0.05),与入院时APN水平呈非线性剂量反应关系,但整体呈负相关(P<0.05)。结论AF患者RFCA术前血清IL-18、APN水平与术后复发有一定关系,二者异常表达可能是复发的风险因子。
Objective To investigate the relationship between serum interleukin-18(IL-18)and adipose tissue(APN)levels before catheterradiofrequency ablation(RFCA)and postoperative recurrence in patients with atrial fibrillation(AF).Methods A prospective study was conducted,selecting 96 AF patients admitted to the First Affiliated Hospital of Zhengzhou University from March 2020 to June 2022 as the study subjects.All patients met the indications for RFCA and received RFCA treatment.They were followed up for 6 months after surgery and were divided into recurrent group and non-recurrent group based on the recurrence of AF during the follow-up period.At the time of admission,general data were collected and relevant laboratory indicators were tested,with a focus on analyzing the relationship between preoperative serum IL-18,APN and postoperative recurrence in patients undergoing RFCA.Results Among the 96 AF patients,28 had postoperative recurrence after RFCA,with a recurrence rate of 29.17%.The proportion of hypertension and coronary heart disease in the recurrent group was higher than that in the non-recurrent group,the left atrial anteroposterior diameter(LAD),serum IL-18 and visfatin levels were higher than those in the non-recurrent group at admission,and the serum APN levels were lower than those in the non-recurrent group at admission,with statistically significant differences(P<0.05).The results of logistic regression analysis showed that high expression of LAD and serum IL-18 at admission in AF patients were risk factors for postoperative recurrence of RFCA(OR>1,P<0.05).High expression of serum APN at admission was a protective factor for recurrence(OR<1,P<0.05).The results of restricted cubic spline analysis showed that there was a linear dose-response relationship between postoperative recurrence of RFCA in AF patients and serum IL-18 levels at admission,with a positive correlation(P<0.05),and a nonlinear dose-response relationship with APN levels at admission,but overall there was a negative correlation(P<0.05).Conclu
作者
刘闯
陈雅丽
李向辉
闫佩佩
LIU Chuang;CHEN Yali;LI Xianghui;YAN Peipei(Department of General,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2023年第17期3131-3135,共5页
Henan Medical Research
关键词
心房颤动
射频消融术
白细胞介素-18
脂联素
复发
atrial fibrillation
catheterradiofrequency ablation
interleukin-18
adipose tissue
recurrence
