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目的分析C反应蛋白(CRP)和降钙素原(PCT)在心房颤动(房颤)患者中的变化及其对房颤患者药物复律成功的预测价值。方法入选2013年1月~2017年1月于邯郸市中心医院急诊科收入院的房颤患者94例,其中男性59例,女性35例,年龄(61.79±0.79)岁。选取同期住院既往无房颤病史的窦性心律患者28例为对照组。将房颤患者依据类型分为阵发性房颤组(63例),持续性房颤组(31例)。检测入选者CRP和PCT水平。运用受试者工作特征曲线(ROC)评价CRP、PCT对房颤、阵发性房颤和持续性房颤患者药物复律成功的预测价值。结果与对照组比较,阵发性房颤组和持续性房颤组CRP、PCT水平均升高,差异有统计学意义(P均<0.05)。持续性房颤组较阵发性房颤组CRP和PCT水平均升高,差异有统计学意义(P均<0.05)。房颤患者CRP水平与PCT呈正相关(r=0.465,P<0.01)。药物转复为窦性心律阵发性房颤组为77.78%,持续性房颤组为51.61%。PCT诊断房颤、阵发性房颤及持续性房颤药物复律成功的ROC曲线下面积(AUC)为0.78、0.79、0.73,CRP诊断的AUC为0.72、0.71、0.62。结论房颤患者CRP和PCT升高,其检测对预测房颤患者药物转复成功有一定价值。
Objective To analyze the changes of C-reactive protein (CRP) and procalcitonin (PCT) in patients with atrial fibrillation (AF) and their predictive value for the success of drug cardioversion in patients with atrial fibrillation. Methods A total of 94 AF patients admitted to the Emergency Department of Handan Central Hospital from January 2013 to January 2017 were selected, 59 males and 35 females, with a mean age of (61.79 ± 0.79) years. Twenty-eight patients with sinus rhythm who had no previous history of atrial fibrillation were selected as the control group. Atrial fibrillation patients were divided into paroxysmal atrial fibrillation group (63 cases), persistent atrial fibrillation group (31 cases). Participants were tested for CRP and PCT levels. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of CRP and PCT in the success of drug cardioversion in patients with atrial fibrillation, paroxysmal atrial fibrillation and persistent atrial fibrillation. Results Compared with the control group, the levels of CRP and PCT in paroxysmal atrial fibrillation group and persistent atrial fibrillation group were increased, the difference was statistically significant (all P <0.05). CRP and PCT levels in persistent AF group were higher than those in paroxysmal AF group (P <0.05). The level of CRP in patients with AF was positively correlated with PCT (r = 0.465, P <0.01). Drug conversion to sinus rhythm paroxysmal atrial fibrillation group was 77.78%, persistent atrial fibrillation group was 51.61%. The area under the ROC curve (AUC) of PCT in diagnosing atrial fibrillation, paroxysmal atrial fibrillation and persistent atrial fibrillation was 0.78, 0.79, 0.73, and the AUC of CRP was 0.72, 0.71, 0.62. Conclusions Patients with atrial fibrillation have elevated CRP and PCT, and their detection may be of value in predicting the success of drug relapse in patients with atrial fibrillation.