目的 探讨血清高敏C反应蛋白(hs-CRP)和肌钙蛋白I(cTnI)与阵发性房颤射频消融术后早期复发的关系.方法 选取2014年10月~2016年9月间于河南科技大学第一附属医院心血管内科首次行三维标测系统(EnSite-NAVX非接触标测)指导下的环肺静脉电隔离术的阵发性房颤患者60例,根据射频消融术后三个月内是否复发(观察指标:患者的自主症状、12导联体表心电图及24 h动态心电图结果等)分为治疗成功组(44例)和复发组(16例),分别在术前、术后第1、2、3 d采集静脉血进行hs-CRP和cTnI水平测定,比较成功组和复发组术前、术后hs-CRP和cTnI变化情况.结果 60例阵发性房颤患者射频消融术后hs-CRP和cTnI浓度峰值水平较术前浓度水平均显著升高,差异有统计学意义(P<0.05).两组患者术前hs-CRP和cTnI水平变化差异无统计学意义(P>0.05).两组患者术后hs-CRP浓度峰值、手术前后hs-CRP浓度最大差值相比较,复发组较成功组均显著升高,差异有统计学意义(P<0.05).两组患者术后cTnI浓度峰值、手术前后cTnI浓度最大差值相比较差异无统计学意义(P>0.05).结论 hs-CRP浓度变化可能与阵发性房颤射频消融术后早期复发有一定关系,而cTnI与阵发性房颤射频消融术后早期复发无明显相关性.
Objective To investigate the relationship among serum high-sensitivity C-reactive protein (hs-CRP), cardiac troponin I (cTnI) and early recurrence of paroxysmal atrial fibrillation (PAF) after radiofrequency ablation (RFA).Methods PAF patients (n=60) were chosen from the Department of Cardiology of the First Affiliated Hospital of Henan University of Science and Technology from Oct. 2014 to Sept. 2016. All patients were received for the first time circumferential pulmonary vein isolation guided by 3-D mapping system (EnSite-NAVX noncontact mapping). The patients were divided into success group (n=44) and recurrence group (n=16) according to PAF recurrence situation (observation indexes including patients'autonomic symptoms, 12-lead electrocardiogram and 24-h ambulatory electrocardiograph results) within 3 months after RFA. The vein blood samples were collected for detecting levels of hs-CRP and cTnI before the operation and on the 1st d, 2nd d and 3rd d after the operation.Results The peak levels of hs-CRP and cTnI increased significantly in 2 groups after the operation (P<0.05). The difference in changes of cTnI and hs-CRP had no statistical significance in 2 groups before the operation (P>0.05). The peak level of hs-CRP after the operation, and the maximum difference of hs-CRP level before and after the operation increased significantly in recurrence group compared with success group (P<0.05). The peak level of cTnI after the operation, and the maximum difference of cTnI level before and after the operation had no statistical difference between 2 groups (P>0.05).Conclusion The changes of hs-CRP level is related to early recurrence of PAF after RFA, while cTnI level is not correlated to that.