目的 分析血浆氨基末端B型脑钠肽前体(nitrogenterminal B type natriureticpeptide precursor,NT-proB-NP)、甘油三酯葡萄糖指数(triglyceride-glucose index,TyG)联合冠状动脉粥样硬化性心脏病-年龄-心房内径-阵发性房颤评分系统(coronary heart disease age atrial diameter paroxysmal atrial fibrillation scoring system,CAAP-AF)预测心房颤动(atrial fibrillation,AF)患者射频消融术后复发的临床价值.方法 226例AF患者根据射频消融术后3个月内是否发生AF复发分为复发组(n=31)和未复发组(n=195).比较两组AF患者年龄、性别、体质量指数(body mass index,BMI)、心功能分级、基础性疾病[冠状动脉粥样硬化性心脏病(以下简称为冠心病)、高血压、2型糖尿病]、吸烟史、饮酒史等临床资料,检测血浆NT-proBNP表达水平及计算TyG,同时进行CAAP-AF评分系统评估.采用多因素Logistic回归分析探讨影响AF患者射频消融术后复发的独立危险因素,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血浆NT-proBNP、TyG联合CAAP-AF评分预测AF患者射频消融术后复发的临床价值.结果 复发组AF患者血浆NT-proBNP表达水平、TyG及CAAP-AF评分均高于未复发组,差异有统计学意义(P均＜0.01).血浆NT-proBNP、TyG及CAAP-AF评分均为影响AF患者射频消融术后复发的独立危险因素(P＜0.05).血浆NT-proBNP、TyG联合CAAP-AF预测AF患者射频消融术后复发的曲线下面积(area under the curve,AUC)为0.829、灵敏度为90.32％,特异度为81.03％,预测价值较高,且均优于血浆NT-proBNP、TyG、CAAP-AF单一指标的预测价值(P＜0.05).结论 血浆NT-proBNP、TyG联合CAAP-AF预测AF患者射频消融术后复发具有较好的临床应用价值,可作为临床预测AF患者射频消融术后复发的参考指标.
Value Research of Plasma NT-proBNP,TyG Combined with CAAP-AF Score in Predicting Recurrence After Radiofrequency Ablation in AF Patients
Objective To analyze the clinical value of plasma nitrogenterminal B type natriureticpeptide precursor(NT-proBNP),triglyceride-glucose index(TyG)combined with coronary heart disease age atrial diameter paroxysmal at-rial fibrillation scoring system(CAAP-AF)in predicting recurrence after radiofrequency ablation in patients with atrial fi-brillation(AF).Methods A total of 226 patients with AF were divided into recurrent group(n=31)and non-recurrent group(n=195)according to whether AF recurred within 3 months after radiofrequency ablation.The clinical data such as age,sex,body mass index(BMI),cardiac function classification,basic diseases(coronary heart disease,hypertension,type 2 diabetes mellitus),smoking history and drinking history of AF patients between the two groups were compared,the expression levels of plasma NT-proBNP were detected,TyG was calculated,and the CAAP-AF scoring system was evaluated.The independent risk factors for the recurrence after radiofrequency ablation in AF patients were investigated by multivariate Logistic regression,and the clinical value of plasma NT-proBNP,TyG combined with CAAP-AF scores in predicting the recurrence after radiofrequency ablation in AF patients was analyzed by receiver operating characteristic(ROC)curve.Results The expression levels of plasma NT-proBNP,TyG and CAAP-AF scores of AF patients in the recurrence group were higher than those in the non-recurrent group,and the difference was statistically significant(all P＜0.01).The plasma NT-proBNP,TyG and CAAP-AF scores were independent risk factors for recurrence after radiofre-quency ablation in AF patients(P＜0.05).The area under the curve(AUC),sensitivity and specificity of plasma NT-proBNP,TyG combined with CAAP-AF in predicting the recurrence after radiofrequency ablation in AF patients were 0.829,90.32％and 81.03％respec-tively,which had high predictive value and were better than single indexes of plasma NT-proBNP,TyG and CAAP-AF(P＜0.05).Conclusion The detection of plasma NT-proBNP and TyG combined with CAAP-AF has a good clinical ap-plication value in the predicting recurrence after radiofrequency ablation in AF patients,which can be used as a clinical ref-erence predictor of recurrence after radiofrequency ablation in AF patients.
Nitrogenterminal B type natriureticpeptide precursorTriglyceride-glucose indexCoronary heart dis-ease age atrial diameter paroxysmal atrial fibrillation scoring systemAtrial fibrillationRadiofrequency ablation
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