血浆转化生长因子β1水平与心房颤动导管射频消融术后复发的关系

张颖

【摘要】 目的：探讨血浆转化生长因子β1（TGF-β1）水平与心房颤动导管射频消融术后复发的关系。方法：选取2016年5月-2017年5月本院接受导管射频消融术治疗的房颤患者60例，根据房颤持续时间分为阵发性房颤36例、持续性房颤24例。患者术前均进行血浆TGF-β1水平、超声心动图等检测，术后随访1年，统计复发情况，分析复发的影响因素。结果：患者均完成1年随访，复发18例（阵发性房颤7例，持续性房颤11例）;复发组阵发性及持续性房颤患者的TGF-β1水平均高于未复发组（P<0.05），且复发、未复发组持续性房颤的TGF-β1水平均高于阵发性房颤（P<0.05）;多因素分析显示，术前TGF-β1水平是阵发性与持续性房颤复发的影响因素（P<0.05）。结论：术前血浆TGF-β1水平是心房颤动导管射频消融术后复发的影响因素，临床治疗中应根据血浆TGF-β1水平进行术后评估，从而做好预防措施，以减少复发率。

【关键词】 血浆转化生长因子β1水平; 心房颤动; 导管射频消融术; 复发

【Abstract】 Objective：To investigate the relationship between plasma transforming growth factor-β1（TGF-β1）level and recurrence of atrial fibrillation after catheter radiofrequency ablation.Method：A total of 60 patients with atrial fibrillation treated by catheter radiofrequency ablation in our hospital from May 2016 to May 2017 were selected.According to the duration of atrial fibrillation，they were divided into 36 cases of paroxysmal atrial fibrillation and 24 cases of persistent atrial fibrillation.The levels of plasma TGF-β1 and echocardiography were measured before operation，they were followed up for 1 year，the recurrence was counted and the influencing factors were analyzed.Result：All patients were followed up for 1 year and 18 cases recurred（7 cases of paroxysmal atrial fibrillation and 11 cases of persistent atrial fibrillation）.The level of TGF-β1 in recurrent group with paroxysmal and persistent atrial fibrillation were higher than those of non-recurrent group（P<0.05）.The levels of TGF-β1 in recurrent and non-recurrent patients with persistent atrial fibrillation were higher than those of paroxysmal atrial fibrillation（P<0.05）.Multivariate analysis showed that preoperative level of TGF-β1 was the influencing factors of recurrent paroxysmal and persistent atrial fibrillation（P<0.05）.Conclusion：Preoperative plasma TGF-β1 level is the influencing factor of recurrence of atrial fibrillation after catheter ablation，in clinical treatment，the level of plasma TGF-β1 should be evaluated postoperatively so as to take preventive measures to reduce recurrence rate.

【Key words】 Plasma transforming growth factor β1 level; Atrial fibrillation; Catheter radiofrequency ablation; Recurrence

First-authors address：Jiamusi Central Hospital，Jiamusi 154003，China

doi：10.3969/j.issn.1674-4985.2019.17.029

心房顫动是心内科常见症状之一，好发于中老年患者[1]。相关研究表明，其与患者的年龄及基础疾病密切相关[2]。房颤患者并发栓塞性疾病的风险大大增加，其死亡率明显高于无房颤者。现有研究证实，对心房颤动患者行肺静脉隔离效果较好，经导管射频消融是治疗房颤的主要方案之一[3]。然而，临床实践发现，房颤患者行经导管射频消融后容易复发，长期效果并不理想。如此一来，如何减少术后患者复发成为当前研究的热点问题。随着进一步探究，现已证实转化生长因子β1（transforming growth factor β1，TGF-β1）与心房颤动的发生密切相关[4]，且有研究认为转化生长因子的水平可作为评估行迷宫术后的风湿性心脏病患者房颤复发指标之一，但其与行房颤导管射频消融术后复发关系鲜有报道。为探究血浆TGF-βl水平与心房颤动导管射频消融术后复发的相关性，本文选取2016年5月-2017年5月本院接受导管射频消融术治疗的房颤患者60例进行研究，现报道如下。……