2020 年第 9 期 第 15 卷

术前高敏C反应蛋白水平对心房颤动患者射频消融术后短期认知功能的影响

Effect of  high sensitive C-reactive protein level on short-term cognitive function after atrial fibrillation radiofrequency ablation

作者：黄曼芸闫晓涵王鑫陆吴永全

英文作者：Huang Manyun Yan Xiaohan Wang Xinlu Wu Yongquan

单位：首都医科大学附属北京安贞医院心内科100029 

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心房颤动；认知障碍；高敏C反应蛋白；射频消融术 

英文关键词：Atrialfibrillation;Cognitiveimpairment;HighsensitiveC-reactiveprotein;Radiofrequencyablation

• 摘要：

• 目的 探讨心房颤动患者射频消融术前高敏C反应蛋白（hs-CRP）水平对术后认知功能的影响。方法 纳入2018年6月至2019年4月于首都医科大学附属北京安贞医院住院的非瓣膜性心房颤动患者108例，根据患者基线hs-CRP检测结果分为hs-CRP正常组73例和hs-CRP升高组35例。比较2组患者基线资料的差异、术前和术后3个月的改良的认知功能电话量表（TICSm）评分及其改善率，分析基线hs-CRP水平是否对术后TICSm评分改善率有影响以及术后TICSm评分改善率的影响因素。结果hs-CRP升高组合并冠状动脉粥样硬化性心脏病比例低于hs-CRP正常组［2.8%(1/35)比19.2%（14/73）］（P＜0.05），2组患者其他基线资料比较差异均无统计学意义（均P＞0.05）。术后3个月随访时2组患者均未出现新发的心脑血管疾病，hs-CRP升高组与hs-CRP正常组TICSm评分均显著高于术前［(37.5±3.3)分比（35.9±2.8）分、(37.2±3.4)分比（34.9±3.8）分］（均P＜0.05）,2组TICSm评分改善率比较差异无统计学意义（P=0.35）。以文化程度、CHA2DS2-VASc评分、HAS-BLED评分、合并冠状动脉粥样硬化性心脏病比例、hs-CRP为自变量，以TICSm评分改善率为因变量进行多元线性回归分析结果表明，仅CHA2DS2-VASc评分对患者认知功能的改善有显著影响（P=0.003），多元线性回归方程为认知功能改善率=6.54+2.6×CHA2DS2-VASc评分，hs-CRP对认知功能的改善无明显影响。结论 心房颤动患者射频消融术后短期认知功能较术前明显改善，但术前hs-CRP水平对心房颤动射频消融术后短期认知功能的改善没有影响。

• Objective To investigate the effect of high-sensitivity C-reactive protein（hs-CRP） on the cognitive function after atrial fibrillation (AF) radiofrequency ablation. Methods The 108 non-valvular AF patients admitted into Beijing Anzhen Hospital, Capital Medical University from June 2018 to April 2019, were divided into normal hs-CRP group with 73 patients and elevated hs-CRP group with 35 patients. Baseline data, Improved Cognitive Function Telephone Scale (TICSm) score improvement rate after ablation of the two groups were analyzed. The relation among hs-CRP level, postoperative TICSm score improvement rate and TICSm score improvement rate was analyzed. Results The proportion of patients with coronary heart disease in elevated hs-CRP group was lower than that in normal hs-CRP group ［2.8%(1/35) vs 19.2%(14/73)］ (P<0.05).There was no significant difference in other baseline data between the two groups(all P>0.05).During the 3 months′ follow-up, no new cerebrovascular diseases occurred in all patients. The postoperative TICSm scores in both groups were significantly higher than before ［elevated hs-CRP group:(37.5±3.3) vs (35.9±2.8)］, normal hs-CRP group: (37.2±3.4) vs (34.9±3.8)］ (both P<0.05). There was no significant difference in the improvement rate of TICSm score between the two groups (P=0.35). Multivariate linear regression analysis showed that only CHA2DS2-VASc score was included in the equation. The cognitive function improvement rate=6.54+2.6×CHA2DS2-VASc score (P=0.003). Hs-CRP showed no significant effect on the postoperative improvement rate of cognitive function. Conclusion Short-term cognitive function after AF radiofrequency ablation is improved significantly, but the hs-CRP level shows no impact on the improvement of short-term cognitive function.