血浆转化生长因子β1水平与心房颤动导管消融后复发的关系研究

摘要

目的:探讨心房颤动(房颤)导管消融术前患者血浆转化生长因子β1(TGF-β1)水平与房颤消融术后复发的关系.方法:连续选取100例接受导管消融治疗的房颤患者,其中阵发性房颤60例,持续性房颤40例.阵发性及持续性房颤患者随访1年后根据房颤复发情况再分为复发组和无复发组.术前检测血浆TGF-β1水平,并行超声心动图等临床检查.结果:所有患者均随访12个月,房颤消融术后的复发率为30%(30/100),其中阵发性房颤术后复发率为21.6%(13/60),持续性房颤复发率为42.5%(17/40).30例房颤术后复发患者术前血浆TGF-β1水平较70例术后无复发患者高[(35.49±8.47)ng/ml vs(27.00±8.61)ng/ml),P<0.05],其中阵发性房颤复发组术前血浆TGF-β1水平较无复发组高,差异有统计学意义[(28.90±8.44)ng/ml vs(22.47±6.64)ng/ml,P<0.05];持续性房颤复发组亦高于无复发组[(40.52±3.37)ng/ml vs(36.26±2.66)ng/ml,P<0.05].对患者年龄、性别、房颤类型、体重指数、左心房内径、左心室射血分数、TGF-β1等多因素logistic回归分析得出术前血浆TGF-β1水平与房颤消融术后复发有关[OR=1.17,95%CI(1.05,1.31),P=0.004].进一步分析显示,术前血浆TGF-β1水平与阵发性房颤的术后复发有关[OR=1.16,95%CI(1.05,1.52),P=0.01],与持续性房颤术后复发也有关[OR=1.71,95%CI(1.12,2.62),P=0.013].结论:房颤消融术前血浆TGF-β1水平与房颤消融术后复发有关.%Objective:To investigate the relationship between pre-operative plasma transforming growth factor-β1 (TGF-β1) level and recurrence of atrial fibrillation ( AF) in patients after catheter ablation.rnMethods:A total of 100 consecutive AF patients were studied,60 of them with paroxysmal AF and 40 with persistent AF,all patients received catheter ablation. The patients were followed-up for 1 year, and then, divided as Recurrence group and Non-recurrence group. The pre-operative plasma TGF-β1 level, echocardiography and other clinical examinations were conducted in all patients.rnResults:During 12 months follow-up period,the total AF recurrence rate was 30% (30/100) including 21. 6% ( 13/60) of paroxysmal AF and 42. 5% ( 17/40) of persistent AF. TGF-β1 level in Recurrence group was higher than that in Non-recurrence group, (35. 49±8. 47)ng/ml vs. (27. 00±8. 61) ng/ml,P<0. 05. In paroxysmal AF patients,TGF-β1 level in AF recurrence patients was higher than that in non-recurrence patients, (28. 90±8. 44)ng/ml vs. (22. 47±6. 64 )ng/ml,P<0. 05 ;and in persistent AF patients, TGF-β1 level in recurrence patients was higher than that in non-recurrence patients, (40. 52 ±3. 37 ) ng/ml vs. (36. 26±2. 66 ) ng/ml, P<0. 05. Multivariate Logistic regression analysis presented that increased TGF-β1 level was significantly relaled to AF recurrence, OR = 1. 17 ,95% CI 1. 05 ,1. 31 ,P = 0. 004 ;further investigation indicated that TGF-β1 level also related to paroxysmal AF recurrence,OR = 1. 16,95%CI 1. 05 ,1. 52,P = 0. 01 and to persistent AF recurrence OR= 1. 71,95% CI 1. 12, 2. 62,P = 0. 013.rnConclusion:P Pre-operative plasma TGF-β1 level related Lo AF recurrence in patients after catheter ablation.