单核细胞与高密度脂蛋白比值对阵发性房颤射频消融术后复发的影响

doi:10.3969/j.issn.1002-1949.2016.05.006

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摘要目的探讨阵发性房颤患者射频消融术前单核细胞与高密度脂蛋白比值（MHR）对术后复发的影响。方法连续收集2011-06～2014-11 在南京医科大学附属常州二院行射频消融的98 例阵发性房颤患者。房颤复发的空白期为3 个月，经过(18.1±5.2)个月的随访，29 例(29.6%)患者出现房颤复发。根据术后房颤是否复发分为复发组和未复发组。测定术前、术后1 周、术后6 个月MHR 值。对复发组与未复发组资料做单因素分析，并进行指标相关性分析和多因素非条件Logistic 回归分析。结果复发组MHR 在术前、术后6 个月均高于未复发组(P＜0.05)。对复发组与未复发组做单因素分析显示，术前房颤病程、年龄、白细胞计数（WBC）、单核细胞计数、高密度脂蛋白（HDL）、单核细胞计数与高密度脂蛋白比值（MHR）、超敏-C 反应蛋白（hs-CRP）及左房前后径（LAD）之间差异有统计学意义(P＜0.05)。MHR 与LAD 呈正相关(P＜0.01), Pearson 相关系数0.378。行多因素非条件Logistic 回归分析示，术前房颤病程[OR 2.631，95％可信区间（CI）1.093～6.335，P＝0.031]和LAD（OR 2.591，95％CI 1.130～5.945，P＝0.025）是阵发性房颤射频消融后的独立危险因素。结论伴有MHR 升高的阵发性房颤患者射频消融后复发率更高，MHR 对阵发性房颤射频术后复发有一定的预测价值，但其他因素同样重要。

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	胡晓
	张静
	周学军
	纪元
	刘宇
	丁志坚

收稿日期: 2015-11-17

基金资助:江苏省常州市卫生局重大项目(ZD201314)

通讯作者: 丁志坚(1956-)，男，硕士，主任医师，副教授，硕士生导师，心血管内科主任，E-mail:dingzhijian@hotmail.com.cn

作者简介: 胡晓（1990-），男，南京医科大学2013 级内科学（心血管病）硕士研究生。

引用本文:

胡晓，张静，周学军，纪元，刘宇，丁志坚. 单核细胞与高密度脂蛋白比值对阵发性房颤射频消融术后复发的影响[J]. 中国急救医学, 2016, 36(5): 406-410.
HU Xiao, ZHANG Jing, ZHOU Xue-jun, JI Yuan, LIU Yu, DING Zhi-jian. Monocyte count-to-HDL cholesterol ratio with the recurrence of paroxysmal atrial fibrillation after catheter ablation. Chinese Journal of Critical Care Medicine, 2016, 36(5): 406-410.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2016.05.006 或 http://www.cnemergency.org.cn/CN/Y2016/V36/I5/406

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