血清脑钠肽、超敏C反应蛋白、可溶性ST2对阵发性心房颤动患者射频消融术后复发的预测价值研究

摘要 目的：探讨血清脑钠肽（BNP）、超敏C反应蛋白（hs-CRP）、可溶性致瘤抑制素2（sST2）对阵发性心房颤动（AF）患者射频消融（RFA）术后复发的预测价值。方法：选择2016年1月至2020年12月我院收治的接受RFA术治疗的82例阵发性AF患者，术后随访12个月，根据术后是否复发分为复发组（25例）和未复发组（57例）。检测患者血清BNP、hs-CRP、sST2水平，收集临床相关资料，采用多因素Logistic回归模型分析影响阵发性AF患者RFA术后复发的因素，采用受试者工作特征（ROC）曲线分析血清BNP、hs-CRP、sST2预测阵发性AF患者RFA术后复发的价值。结果：复发组血清BNP、hs-CRP、sST2水平高于未复发组（P＜0.05）。血清BNP、hs-CRP、sST2水平升高、AF病程增长是影响阵发性AF患者RFA术后复发的危险因素（P＜0.05）。血清BNP、hs-CRP、sST2预测阵发性AF患者消融术后复发的曲线下面积分别为0.720、0.694、0.718，联合三者预测阵发性AF患者RFA术后复发的曲线下面积为0.866，高于BNP、hs-CRP、sST2单独预测。结论：阵发性AF患者血清BNP、hs-CRP、sST2水平升高是RFA术后复发的危险因素，联合检测血清BNP、hs-CRP、sST2水平有助于预测阵发性AF患者RFA术后复发。

Predictive Value of Serum Brain Natriuretic Peptide, High-Sensitivity C-Reactive Protein and Soluble ST2 on Recurrence after Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation

ABSTRACT Objective: To investigate the predictive value of serum brain natriuretic peptide (BNP), high-sensitivity C-reactive protein (hs-CRP) and soluble tumorigenic inhibin 2 (sST2) in the recurrence after radiofrequency ablation (RFA) in patients with paroxysmal atrial fibrillation (AF). Methods: 82 patients with paroxysmal AF who were treated by RFA in our hospital from January 2016 to December 2020 were selected. They were followed up for 12 months. They were divided into recurrence group (25 cases) and non recurrence group (57 cases) according to whether they relapsed after operation. The levels of serum BNP, hs-CRP and ST2 were detected, and the relevant clinical data were collected. The factors affecting the postoperative recurrence of RFA in patients with paroxysmal AF were analyzed by multivariate Logistic regression model. The value of serum BNP, hs-CRP and sST2 in predicting the postoperative recurrence of RFA in patients with paroxysmal AF was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum BNP, hs-CRP and sST2 in recurrent group were higher than those in non recurrent group(P<0.05). The increase of serum BNP, hs-CRP, sST2 and the AF course were the risk factors of recurrence after RFA in patients with paroxysmal AF(P<0.05). The area under the curve of serum BNP, hs-CRP and sST2 predicting the recurrence after ablation in patients with paroxysmal AF was 0.720, 0.694 and 0.718 respectively. The area under the curve of combining the three to predict the recurrence after RFA in patients with paroxysmal AF was 0.866, which was higher than that predicted by BNP, hs-CRP and sST2 alone. Conclusion: The elevated levels of serum BNP, hs-CRP and sST2 in patients with paroxysmal AF are the risk factors for postoperative recurrence of RFA. Combined detection of serum BNP, hs-CRP and sST2 levels is helpful to predict postoperative recurrence of RFA in patients with paroxysmal AF.