文章摘要
游杨杨,苏浩,徐健,朱红军,沈伟,周晓娟,周足金,张理想.多指标联合预测阵发性心房颤动导管消融术后复发的研究[J].中国临床保健杂志,2019,22(6):809-813.
多指标联合预测阵发性心房颤动导管消融术后复发的研究
A research of multiple combined detection for predicting paroxysmal atrial fibrillation recurrence after radiofrequency catheter ablation
投稿时间:2019-10-22  
DOI:10.3969/J.issn.1672-6790.2019.06.023
中文关键词: 心房颤动  导管消融术  复发  预测  诊断技术,心血管
英文关键词: Atrial fibrillation  Catheter ablation  Recurrence  Forecasting  Diagnostic techniques,cardiovascular 〖FL
基金项目:中央引导地方科技发展专项(2017070802D145)
作者单位E-mail
游杨杨 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
苏浩 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
徐健 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
朱红军 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
沈伟 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
周晓娟 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
周足金 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
张理想 [中国科学技术大学附属第一医院安徽省立医院心血管内科,合肥 230001] 958532006@qq.com 
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中文摘要:
      目的 探讨阵发性心房颤动术后复发相关危险因素以及多指标联合检测评估阵发性心房颤动复发风险评估的价值。 方法 选取318例行阵发性心房颤动消融的手术患者,根据1年内随访的结果分别分为复发组50例和未复发组268例。分别监测患者的生化指标以及心脏超声指标,并构建三种指标联合(中性粒细胞/淋巴细胞比值、左房内径和左房容积指数)的新的联合指标预测模型对于阵发性心房颤动导管消融术后的复发风险进行评估。 结果 两组患者性别、年龄、高血压病史、糖尿病史、左室舒张末内径、左室射血分数、肺动脉压力、甲状腺功能、球蛋白差异无统计学意义。尿酸、中性粒细胞/淋巴细胞比值、左房内径、左房容积指数差异有统计学意义。中性粒细胞/淋巴细胞比值、左房内径、左房容积指数为阵发性心房颤动复发预测的危险因素。分别比较新的联合指标、左房内径、左房容积指数、中性粒细胞/淋巴细胞比值预测阵发性心房颤动术后心房颤动复发的受试者工作特征的曲线下面积(AUC)。新的联合指标预测阵发性心房颤动术后复发的AUC为0.918,灵敏度为0.820,特异度为0.899;中性粒细胞/淋巴细胞比值预测阵发性心房颤动术后复发的AUC为0.792,灵敏度为0.660,特异度为0.951;左房内径预测阵发性心房颤动术后复发的AUC为0.661,灵敏度为0.560,特异度为0.724;左房容积指数预测阵发性心房颤动术后复发的AUC为0.876,灵敏度为0.900,特异度为0.716。 结论 中性粒细胞/淋巴细胞比值、左房内径和左房容积指数联合对阵发性心房颤动术后复发的预测风险评估价值高于任何单一指标,预测阵发性心房颤动术后复发更可靠。
英文摘要:
      Objective To investigate the risk factors of recurrence after radiofrequency catheter ablation and analyze the value of the prediction effect evaluation of the multiple combined detection in patients with paroxysmal atrial fibrillation.Methods 318 patients with paroxysmal atrial fibrillation who were treated radiofrequency catheter ablation were selected.According to whether recurrence occurred or not,the patients were divided into recurrence group(n=50) and non-recurrence group(n=268) after 1-year follow-up period.Relevant indicators were detected in two groups and the combined prediction model which consisted of three indicators including NLR LA and LAVI were built to predict the risk of recurrence in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation.Results There were no significant differences in gender,age,history of hypertension,history of diabetes mellitus,LV,LVEF,SPAP,FT3,FT4,TSH and Glb between the two groups.There were significant differences in UA,NLR,LA and LAVI between the two groups.NLR,LA and LAVI are predictive factors for paroxysmal atrial fibrillation recurrence after the operation.The areas under the curve(AUC)of receiver operating characteristic(ROC)were compared that included the new combined index Logit(P),LA,LAVI and NLR.The area under the curve(AUC)of receiver operating characteristic(ROC)predicted by the new combined indicator was 0.918 and the sensitivity and specificity were 0.820 and 0.899 respectively.The AUC of ROC predicted by NLR was 0.792 and the sensitivity and specificity were 0.660 and 0.951 respectively.The AUC of ROC predicted by LA was 0.661 and the sensitivity and specificity were 0.560 and 0.724 respectively.The AUC of ROC predicted by LAVI was 0.876 and the sensitivity and specificity were 0.900 and 0.716 respectively.There were significant differences when the AUC of ROC of NLR,LA and LAVI were compared with the new combined indicator respectively.The AUC of ROC occurring in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation predicted by NLR and LA were significantly different.The AUC of ROC occurring in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation predicted by LA and LAVI were significantly different.The AUC of ROC occurring in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation predicted by NLR and LAVI were not significantly different.Conclusions LA,LAVI and NLR combination detection is more valuable and reliable method than any single indicator in predicting the risk of recurrence in patients with paroxysmal atrial fibrillation after radiofrequency catheter ablation.
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