[1]李培成,赵良平,刘 辉,等.导管射频消融术对心房颤动患者心功能及血清心肌酶和炎症因子水平的影响[J].新乡医学院学报,2020,37(6):592-596.[doi:10.7683/xxyxyxb.2020.06.021]
 LI Peicheng,ZHAO Liangping,LIU Hui,et al.Effects of radiofrequency catheter ablation on heart function and serum myocardial enzymes and inflammatory factors levels in patients with atrial fibrillation[J].Journal of Xinxiang Medical University,2020,37(6):592-596.[doi:10.7683/xxyxyxb.2020.06.021]
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导管射频消融术对心房颤动患者心功能及血清心肌酶和炎症因子水平的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年6
页码:
592-596
栏目:
临床研究
出版日期:
2020-06-05

文章信息/Info

Title:
Effects of radiofrequency catheter ablation on heart function and serum myocardial enzymes and inflammatory factors levels in patients with atrial fibrillation
作者:
李培成赵良平刘 辉郭军霞张跃光
(新乡医学院第一附属医院心血管内科,河南 卫辉 453100)
Author(s):
LI PeichengZHAO LiangpingLIU HuiGUO JunxiaZHANG Yueguang
(Department of Cardiovascular Medicine,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
导管射频消融术心房颤动心肌酶心功能白细胞介素-6高敏C反应蛋白
Keywords:
radiofrequency catheter ablationatrial fibrillationmyocardial enzymeheart functioninterleukin-6high sensitive C-reactive protein
分类号:
R541.7
DOI:
10.7683/xxyxyxb.2020.06.021
文献标志码:
A
摘要:
目的 探讨导管射频消融术对心房颤动患者心功能及血清心肌酶和炎症因子水平的影响。方法 选择2016年11月至2019年1月新乡医学院第一附属医院收治的112例心房颤动患者为研究对象,根据随机数字表法将患者分为射频消融组和对照组,每组56例。对照组患者给予β受体阻滞剂、洋地黄制剂等常规药物治疗,射频消融组患者给予导管射频消融术治疗。分别于术前、术后即刻及术后1、7 d采用酶联免疫吸附试验检测射频消融组患者血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)、高敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平;治疗前和治疗后6个月,使用彩色多普勒超声仪检查2组患者左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左心室射血分数(LVEF),采用美国纽约心脏病学会(NYHA)心功能分级标准评估患者心功能分级,并进行6 min步行试验。结果 射频消融组患者术后即刻血清CK、CK-MB、LDH、AST、hs-CRP、IL-6水平高于术前(P<0.05),射频消融组患者术后1、7 d血清CK、CK-MB、LDH、AST、hs-CRP、IL-6水平低于术后即刻(P<0.05),射频消融组患者术后1、7 d血清CK、CK-MB、LDH、AST水平与术前比较差异无统计学意义(P>0.05),射频消融组患者术后7 d血清hs-CRP和IL-6水平低于术后1 d(P<0.05),射频消融组患者术后7 d血清hs-CRP和IL-6水平与术前比较差异无统计学意义(P>0.05)。治疗前2组患者LAD、LVEDD、LVESD、LVEF比较差异均无统计学意义(P>0.05);2组患者治疗后6个月LAD、LVEDD、LVESD小于治疗前,LVEF大于治疗前(P<0.05);治疗后6个月,射频消融组患者LAD、LVEDD、LVESD小于对照组,LVEF大于对照组(P<0.05)。治疗前2组患者心功能分级比较差异无统计学意义(P>0.05),对照组患者治疗后6个月与治疗前心功能分级比较差异无统计学意义(P>0.05),射频消融组患者治疗后6个月心功能分级优于治疗前(P<0.05);治疗后6个月,射频消融组心功能分级优于对照组(P<0.05)。2组患者治疗前6 min步行距离比较差异无统计学意义(P>0.05),对照组患者治疗后6个月与治疗前6 min步行距离比较差异无统计学意义(P>0.05),射频消融组患者治疗后6个月6 min步行距离大于治疗前(P<0.05);治疗后6个月,射频消融组患者6 min步行距离大于对照组(P<0.05)。结论 导管射频消融术可显著改善心房颤动患者的心功能,虽能引发心肌细胞炎性损伤,但这种损伤短时间内即可恢复。
Abstract:
Objective To investigate the effect of radiofrequency catheter ablation on heart function,serum myocardial enzymes and inflammatory factors levels in patients with atrial fibrillation.Methods A total of 112 patients with atrial fibrillation admitted to the First Affiliated Hospital of Xinxiang Medical University from November 2016 to January 2019 were selected as the study objects,and the patients were divided into radiofrequency ablation group and control group according to the random number table method,with 56 cases in each group.The patients in the control group were treated with β-receptor blocker,digitalis preparation and other conventional drugs,while the patients in the radiofrequency ablation group were treated with radiofrequency catheter ablation.The levels of serum creatine kinase (CK),creatine kinase isoenzyme (CK-MB),lactate dehydrogenase (LDH),aspartate transaminase (AST),high sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent assay at the time points of before operation,the end of the operation and 1,7 days after operation.Before and 6 months after treatment,the left atrial diameter (LAD),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were measured by color Doppler ultrasound;the heart function grading of the patients was assessed by New York Heart Association standard,and the 6-minute walking test was carried out.Results In the radiofrequency ablation group,the levels of serum CK,CK-MB,LDH,AST,hs-CRP and IL-6 at the end of the operation were higher than those before operation (P<0.05);the levels of serum CK,CK-MB,LDH,AST,hs-CRP and IL-6 at one and seven days after operation were lower than those at the end of the operation (P<0.05);there was no significant difference in serum CK,CK-MB,LDH and AST levels at the time points of before operation and 1,7 days after operation (P>0.05);the levels of serum hs-CRP and IL-6 at 7 days after operation were lower than those at one day after operation (P<0.05);there was no significant difference in the levels of serum hs-CRP and IL-6 at 7 days after operation and before operation (P>0.05).There was no significant difference in the LAD,LVEDD,LVESD and LVEF between the two groups before treatment (P>0.05).Compared with before treatment,the LAD,LVEDD and LVESD decreased and the LVEF increased in the two groups at 6 months after treatment (P<0.05).Compared with the control group,the LAD,LVEDD and LVESD decreased and the LVEF increased in the radiofrequency ablation group at 6 months after treatment (P<0.05).There was no significant difference in heart function of patients between the two groups before treatment (P>0.05).There was no significant difference in heart function classification at 6 months after treatment and before operation in the control group (P>0.05),but the heart function grading at 6 months after treatment was better than that before treatment in the radiofrequency ablation group (P<0.05).The heart function grading in the radiofrequency ablation group was better than that in the control group at 6 months after treatment (P<0.05).There was no significant difference in the 6-minute walking distance between the two groups before treatment (P>0.05).There was no significant difference in the 6-minute walking distance at 6 months after treatment and before treatment in the control group (P>0.05),but the 6-minute walking distance at 6 months after treatment was significantly higher than that before treatment in the radiofrequency ablation group (P<0.05).The 6-minute walking distance of patients in the radiofrequency ablation group was larger than that in the control group at 6 months after treatment (P<0.05).Conclusion Radiofrequency catheter ablation can significantly improve the heart function of patients with atrial fibrillation.Although it can cause inflammatory injury of myocardial cells,the injury can be recovered in a short time.

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更新日期/Last Update: 2020-06-05