阵发性心房颤动导管射频消融术后复发的危险因素分析

赵世佳

【摘要】 目的：分析陣发性心房颤动导管射频消融术后复发的危险因素。方法：回顾性分析2012年1月-2019年1月在本院心内科明确诊断为阵发性心房颤动并行射频消融术的150例患者的临床资料。根据患者术后随访情况分为非复发组（n=100）和复发组（n=50）。分析影响阵发性心房颤动导管射频消融术后复发的危险因素。结果：两组吸烟、饮酒、合并高血压、合并糖尿病、合并冠心病、LVEF、LADI、左心房前后径、右心房上下径、CRP、UA、Ccr、Hcy、三酰甘油比较，差异均无统计学意义（P>0.05）。两组房颤病程、CHA2DS2-VASc评分、术后住院时间比较，差异均有统计学意义（P<0.05）。logistic回归分析显示，房颤病程≥36个月和CHA2DS2-VASc评分≥2分、术后住院时间是阵发性心房颤动导管射频消融术复发的危险因素（P<0.05）。结论：房颤病程长、CHA2DS2-VASc评分高、术后住院时间长是阵发性房颤患者导管射频消融术后复发的独立危险因素，诊断过程中识别危险因素、个体化治疗、定期术后随访具有重要的临床价值。

【关键词】 导管射频消融术 阵发性心房颤动 复发 危险因素

[Abstract] Objective： To analyze the risk factors of recurrence after catheter radiofrequency ablation of paroxysmal atrial fibrillation. Method： A retrospective analysis was performed on the clinical data of 150 patients diagnosed with paroxysmal atrial fibrillation and underwent radiofrequency ablation in the department of cardiology of our hospital from January 2012 to January 2019. Patients were divided into non-recurrent group （n=100） and recurrent group （n=50） according to postoperative follow-up. The risk factors of recurrent atrial fibrillation after radiofrequency catheter ablation were analyzed. Result： Comparison of smoking， drinking， combined hypertension， combined diabetes， combined coronary heart disease， LVEF， LADI， anterior and posterior diameter of left atrium， upper and lower diameter of right atrium， CRP， UA， Ccr， Hcy and triglyceride between the two groups， there were no significant differences （P>0.05）. Comparison of atrial fibrillation course， CHA2DS2-VASc score and postoperative hospital stay between the two groups， the differences were statistically significant （P<0.05）. logistic regression analysis showed that atrial fibrillation course ≥36 months， CHA2DS2-VASc score ≥2， and postoperative hospital stay were risk factors for recurrence of catheter radiofrequency ablation for paroxysmal atrial fibrillation （P<0.05）. Conclusion： Long course of atrial fibrillation， high CHA2DS2-VASc score， and long postoperative hospital stay time are independent risk factors for recurrence of paroxysmal atrial fibrillation patients after catheter radiofrequency ablation. Identification of risk factors during diagnosis， individualized treatment and regular postoperative follow-up are of important clinical value.

[Key words] Catheter radiofrequency ablation Paroxysmal atrial fibrillation Recurrence Risk factors

First-author’s address： Huludao Central Hospital， Huludao 125000， China

doi：10.3969/j.issn.1674-4985.2021.25.031

心房颤动又称为房颤，是一种常见的心律失常，随着年龄的增加患病率增加，可引发痴呆、心力衰竭、卒中、痴呆等，易致残和致死，其防治成为心血管内科的重要任务[1]。导管射频消融术是治疗阵发性心房颤动的重要方法，疗效肯定，具有安全、微创、短期效果显著的特点，是临床治疗阵发性心房颤动的首选方式，虽然技术有了很大改进，但是术后房颤的复发率仍较高，因此研究其术后复发的危险因素十分必要[2-3]。……