付蕾　孙国建　何浪

[摘要] 目的 探讨心房颤动导管消融术后早期复发与炎症反应和细胞外基质生物标志物间的关系。 方法 选取我院自2014年1月～2015年1月间收治的进行心导管消融术患者62例作为研究对象，测定该组患者手术前后高敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶抑制剂-2（TIMP-2），对比术后早期复发患者和未复发患者各指标的水平差异。 结果 复发组患者和未复发组患者的房颤类型、性别、年龄差异无统计学意义（P>0.05）；复发组患者术前IL-6、hs-CRP、MMP-2均显著高于未复发组，组间比较差异有统计学意义（P<0.05）；两组术前TIMP-2指标差异无统计学意义（P>0.05）。 结论 心房颤动患者行RFCA治疗后早期复发与机体炎症反应、MMP-2水平变化息息相关，因此可以作为防治复发的判断依据。

[关键词] 心房颤动；心导管消融术；IL-6；hs-CRP；MMP-2

[中图分类号] R541 [文献标识码] A [文章编号] 1673-9701（2017）24-0026-04

[Abstract] Objective To investigate the relationship between early recurrenceafter catheter ablation of atrial fibrillation and inflammatory response， extracellular matrix biomarkers. Methods 62 patients who underwent cardiac catheter ablation from January 2014 to January 2015 in our hospital were selected.The high sensitivity C-reactive protein（hs-CRP）， interleukin-6（IL-6）， matrix metalloproteinase-2（MMP-2） and tissue inhibitor of metalloproteinase-2（TIMP-2） in the patients before and after surgery were detected. The differences in the levels of each indicator between the early postoperative recurrence patients and non-recurrence patients were compared. Results The differences were no statistically significant in the type of atrial fibrillation， sex and age between the recurrence group and the non-recurrence group（P>0.05）. The levels of IL-6， hs-CRP and MMP-2 in the recurrence group were significantly higher than those of the non-recurrence group， and the differences were statistically significant（P<0.05）. The difference was no statistically significant in the preoperative TIMP-2 between the two groups（P>0.05）. Conclusion Early recurrence in patients with atrial fibrillation after undergoing RFCA treatment is closely related to the inflammatory response and the change of MMP-2 level， so it can be used as the basis for the prevention and treatment of recurrence.

[Key words] Atrial fibrillation； Cardiac catheter ablation； IL-6； Hs-CRP； MMP-2

心房颤动（auricular fibrillation，AF）是由心房促使折返环产生大量小折返环导致心律紊乱失常的病症。房颤会引起动脉栓塞、心力衰竭等非常严重的并发症，对患者的生命健康造成巨大影响[1]。导管消融术（RFCA）是经心导管把射频电流引入心脏，将特定部位的心肌细胞进行消融处理以去除病灶的治疗手段，目前RFCA手术不断成熟提高了患者的治疗成功率，但术后早期复发率较高影响了治疗效果[2]。因此，研究影响RFCA术后早期复发的因素成为临床预防和控制疾病复发的关键，相关研究表明心房组织纤维化、炎性反应可能是诱发术后早期复发的主因，本文则抽选46例采用RFCA治療的房颤患者术前测定期炎性标记物和细胞外基质生物标志物情况，评估各项指标与术后早期复发间的关系。