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目的:观察心房颤动患者与窦性心律者,心房颤动射频消融术后心房颤动复发及未复发患者中,血清中EB病毒衣壳抗原Ig G抗体(EBV-VCA Ig G抗体)水平,以评估其在预测心房颤动发生及射频消融术后复发的作用。方法:连续入选中国心房颤动注册研究(CAFR)中孤立性心房颤动患者103例,并将流行病调查研究中4 209窦性心律者作为对照组对象来源,经匹配后分别为48例进行分析,比较两组临床特点及EBV-VCA Ig G抗体水平;整体孤立性心房颤动患者与匹配后心房颤动患者根据射频消融术后是否复发分别分为两组,比较两组基线资料及EBV-VCA Ig G抗体水平。结果:比较发现心房颤动组患者组EBV-VCA Ig G抗体较对照组高[(75.91±14.92)vs.(51.08±11.89)μg/m L,P<0.001],经Logistic回归分析提示EBV-VCA Ig G抗体水平与心房颤动发生存在相关性(OR=1.140,95%CI:1.078~1.205,P<0.001);当EBV-VCA Ig G抗体截断值为68.35μg/m L时的预测敏感度为77.1%,特异度为99.0%(95%CI:0.835~0.965,P<0.001)。但经多因素Cox回归分析未发现EBV-VCA Ig G抗体水平为心房颤动射频消融术后复发的独立危险因素。结论:本研究证实EBV-VCA Ig G抗体水平可能参与心房颤动的发生机制,且对心房颤动的发病具有较好的预测价值。
OBJECTIVE: To observe the level of Epstein-Barr virus capsid antigen Ig G antibody (EBV-VCA Ig G antibody) in serum of patients with atrial fibrillation and sinus rhythm, atrial fibrillation after atrial fibrillation recurrence and non-recurrence of atrial fibrillation In predicting the occurrence of atrial fibrillation and recurrence after radiofrequency ablation. Methods: A total of 103 consecutive patients with isolated atrial fibrillation (CAFR) were enrolled in this study. Four hundred and seventy-nine patients with sinus rhythm in the epidemiological investigation were selected as the control group, and 48 cases were matched respectively. The clinical features and EBV-VCA Ig G antibody levels were compared between the two groups. Baseline data and EBV-VCA Ig G were compared between patients with global isolated atrial fibrillation and patients with matched atrial fibrillation after radiofrequency ablation. Antibody level. Results: Compared with control group, EBV-VCA Ig G antibody in patients with atrial fibrillation was significantly higher than that in control group [(75.91 ± 14.92) vs. (51.08 ± 11.89) μg / m L, P <0.001) The level of Ig G antibody correlated with the occurrence of atrial fibrillation (OR = 1.140, 95% CI: 1.078-1.205, P <0.001). The predictive sensitivity of EBV-VCA Ig G antibody was 68.35 μg / 77.1% with a specificity of 99.0% (95% CI: 0.835-0.965, P <0.001). However, multivariate Cox regression analysis did not find that EBV-VCA Ig G antibody level was an independent risk factor for recurrence after atrial fibrillation radiofrequency ablation. CONCLUSIONS: This study demonstrates that the antibody level of EBV-VCA Ig G may be involved in the pathogenesis of atrial fibrillation and has a good predictive value for the incidence of atrial fibrillation.