1 成都市龙泉驿区第一人民医院心内科，成都 610100
2 四川大学华西医院心内科，成都 610041
目的：探究血清同型半胱氨酸(homocysteine，Hcy)、脑钠肽(brain natriuretic peptide，BNP)水平对心房颤动(atrial fibrillation，AF)患者射频消融术后复发的预测价值。方法：选择2016年1月至2018年10月成都市龙泉驿区第一人民医院心内科收治的95例AF患者为AF组，选择同期体格检查健康的成年人为对照组。两组受试者均于入院后测定血清Hcy和BNP水平，AF组接受射频消融术后进行为期12个月的随访，统计复发情况，分析AF患者复发的危险因素及血清Hcy和BNP的预测价值。结果：AF组患者血清Hcy和BNP水平显著高于对照组受试者(P<0.05)。AF患者术后随访复发32例，复发率为33.68%；经比较，复发组患者高血压、糖尿病比例显著高于未复发组(P<0.05)；左心房直径、血清Hcy和BNP水平显著高于未复发组，差异具统计学意义(P<0.05)。Logistic多因素分析示：在矫正其他影响因素后，高血清Hcy和BNP水平是AF患者射频消融术术后复发的独立危险因素(P<0.05)。血清Hcy和BNP预测复发的曲线下面积(area under the area，AUC)分别为0.774，0.828，预测最佳截点值分别为25.7 μmol/L，78.4 pg/mL；两者联合预测复发的曲线下面积为0.865。结论：血清Hcy和BNP水平与AF患者射频消融术后复发相关，临床可根据截点值筛选复发高风险人群，进行病情检测及早期干预。关键词： 同型半胱氨酸；脑钠肽；心房颤动；射频消融术；复发
Predictive value of serum homocysteine and brain natriuretic peptide levels for recurrence of patients with atrial fibrillation after radiofrequency ablation
CorrespondingAuthor: FU Hua Email: firstname.lastname@example.org
Foundation: This work was supported by Chengdu Medical Research Project, China (2018116).
Objective: To explore predictive value of serum homocysteine (Hcy) and brain natriuretic peptide (BNP) levels for recurrence of patients with atrial fibrillation (AF) after radiofrequency ablation (RFA). Methods: During the period from January 2016 to October 2018, 95 AF patients who were admitted to cardiology department of the hospital and healthy adults who underwent physical examination during the same period were enrolled as study objects. They were included into AF group and control group, respectively. After admission, all in both groups were tested for serum Hcy and BNP levels. After RFA, AF group underwent 12-month follow-up. The recurrence situation was statistically analyzed. The risk factors of recurrence in AF patients and predictive value of serum Hcy and BNP were analyzed. Results: The levels of serum Hcy and BNP in AF group were significantly higher than those in control group (P<0.05). The postoperative follow-up for AF patients showed that there were 32 cases with recurrence, with recurrence rate of 33.68%. After comparison, proportion of patients with hypertension and diabetes mellitus in recurrence group was significantly higher than that in non-recurrence group (P<0.05), left atrial diameter, levels of serum Hcy and BNP were significantly higher than those in non-recurrence group (P<0.05). Logistic multivariate analysis showed that after correcting other influencing factors, high serum Hcy and BNP levels were independent risk factors of recurrence in AF patients after RFA (P<0.05). The areas under the curve (AUC) of serum Hcy and BNP for predicting recurrence were 0.774 and 0.828, respectively. Their best cut-off values were 25.7 μmol/L and 78.4 pg/mL, respectively. The area under the curve of the two for predicting recurrence was 0.865. Conclusion: Serum Hcy and BNP levels are related to recurrence in AF patients after RFA. Clinically, high-risk recurrence populations can be screened out based on cut-off values for disease detection and early intervention.Keywords： homocysteine; brain natriuretic peptide; atrial fibrillation; radiofrequency ablation; recurrence