CAJ | 학술논문

目的：观察心房颤动（AF）患者导管消融术前后血浆脂蛋白相关性磷脂酶 A2（Lp-PLA2）含量变化的特点，探索心房颤动导管消融术后早期复发的病理生理学机制及预测因子。方法连续选取经临床和辅助检查确诊且接受导管消融治疗的85例房颤患者，其中阵发性房颤54例，持续性房颤31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 Lp-PLA2水平，并行超声心动图等辅助检查。结果随访12个月，房颤消融术后的复发率为28.2%，其中阵发性房颤术后复发率为22.2%，持续性房颤复发率为38.7%。24例房颤术后复发患者术前血浆 LP-PLA2水平较61例术后无复发患者显著升高[（195.8±13.1）ng/ ml vs（171.6±10.5）ng/ ml，P <0.05]。对85例患者年龄、性别、房颤类型、体质量指数、左心房内径、左心室射血分数、LP-PLA2等因素 Logistic 回归分析显示，术前血浆 LP-PLA2水平与房颤导管消融术后复发相关[OR =1.18，95% CI（1.06~1.30），P =0.003]。结论房颤消融术前血浆 Lp-PLA2水平与房颤消融术后复发相关， LP-PLA2可作为一种分子标记物用于房颤消融术后复发预测。
목적：관찰심방전동（AF）환자도관소융술전후혈장지단백상관성린지매 A2（Lp-PLA2）함량변화적특점，탐색심방전동도관소융술후조기복발적병리생이학궤제급예측인자。방법련속선취경림상화보조검사학진차접수도관소융치료적85례방전환자，기중진발성방전54례，지속성방전31례。진발성급지속성방전환자수방1년후，근거방전복발정황재분위복발조화무복발조。술전검측혈장 Lp-PLA2수평，병행초성심동도등보조검사。결과수방12개월，방전소융술후적복발솔위28.2%，기중진발성방전술후복발솔위22.2%，지속성방전복발솔위38.7%。24례방전술후복발환자술전혈장 LP-PLA2수평교61례술후무복발환자현저승고[（195.8±13.1）ng/ ml vs（171.6±10.5）ng/ ml，P <0.05]。대85례환자년령、성별、방전류형、체질량지수、좌심방내경、좌심실사혈분수、LP-PLA2등인소 Logistic 회귀분석현시，술전혈장 LP-PLA2수평여방전도관소융술후복발상관[OR =1.18，95% CI（1.06~1.30），P =0.003]。결론방전소융술전혈장 Lp-PLA2수평여방전소융술후복발상관， LP-PLA2가작위일충분자표기물용우방전소융술후복발예측。
Objective To observe the relationship between pre-operative plasma lipoprotein-as-sociated phospholipase A2(LP-PLA2)levels and recurrence of atrial fibrillation( AF)in patients after catheter ablation. Methods A total of 85 consecutive AF patients were studied,54 of them with paroxys-mal AF and 31 with persistent AF,all patients received catheter ablation. The patients were followed-up for 1 year,and then were divided in to recurrence group and non-recurrence group. The pre-operative plasma LP-PLA2 level,echocardiography and other clinical examinations were conducted in all patients. Results During the 12 months follow-up period,the total AF recurrence rate was 28. 2%(24 / 85),in-cluding 22. 2%(12 / 54)of paroxysmal AF and 38. 7%(12 / 31)of persistent AF. The LP-PLA2 level in recurrence group was higher than that in non-recurrence group[(195. 8 ± 13. 1)ng / ml vs(171. 6 ± 10. 5)ng / ml,P < 0. 05]. In paroxysmal AF patients,LP-PLA2 level in AF recurrence patients was higher than that in non-recurrence patients(P < 0. 05);and in persistent AF patients,LP-PLA2 level in recurrence patients was higher than that in non-recurrence patients(P < 0. 05). Multivariate Logistic re-gression analysis presented that increased LP-PLA2 level was significantly correlated with AF recurrence [OR = 1. 18,95% CI(1. 06 - 1. 30),P = 0. 003]. Conclusions Pre-operative plasma LP-PLA2 is cor-related with AF recurrence in patients after catheter ablation,and LP-PLA2 may be used as a useful mark-er for the predicting of AF recurrence after ablation.