Abstract:

Objective　To investigate the predictive value of neutrophil lymphocyte ratio (NLR) combined with N-terminal brain natriuretic peptide (NT-proBNP) for early recurrence of persistent atrial fibrillation after radiofrequency ablation. Methods　From October 2019 to May 2022, 102 patients with persistent atrial fibrillation after radiofrequency ablation treated in Liaocheng Second People's Hospital were selected as the study objects. The patients' early recurrences during the 1 month in hospital were counted. According to whether they relapsed, they were divided into a recurrent group and a non-recurrent group. The clinical data were compared between these two groups. Logistic multivariate regression analysis was used to analyze the factors influencing the early recurrence. The values of NLR and NT-proBNP in the prediction of early recurrence were analyzed. The data were analyzed by t test, χ² test, and Fisher's exact test. Results　Sixteen patients recurred early after radiofrequency ablation, with a recurrence rate of 15.69%. There were no statistical differences in age, diabetes, hypertension, stroke, drinking, smoking, hyperlipidemia, serum albumin, and tumor necrosis factor- α (TNF-α) between these two groups (all P>0.05). The NLR and NT-proBNP levels in the recurrent group were higher than those in the non-recurrent group [(9.25±1.52) vs. (5.36±1.21) and (902.52±109.25) ng/L vs. (278.52±20.58) ng/L], with statistical differences (both P<0.05). With NLR and NT-proBNP as the independent variables (all were continuous variables), whether the patient recur red during hospitalization as the dependent variable (recurrence=1, no recurrence=0), logistic regression analysis was conducted; the results showed that NLR and NT-proBNP were risk factors for the early recurrence after radiofrequency ablation of persistent atrial fibrillation (both P<0.05). The receiver operating characteristic curve (ROC) analysis showed that the sensitivity, specificity, and area under curve (AUC) of NLR combined with NT-proBNP in predicting the recurrence of the patients with persistent atrial fibrillation after radiofrequency ablation were 72.73%, 97.70%, and 0.884, respectively. The specificity and AUC of NLR combined with NT-proBNP in predicting recurrence of persistent atrial fibrillation after radiofrequency ablation were higher than those of single prediction (all P<0.05). Conclusion　NLR and NT-proBNP are effective in predicting recurrence of persistent atrial fibrillation after radiofrequency ablation, but their combined predictive value is higher.

Key words:

Persistent atrial fibrillation, Neutrophil to lymphocyte ratio, Plasma N-terminal brain natriuretic peptide precursor, Predictive value,  , Specificity

摘要：

目的　探究中性粒细胞/淋巴细胞比值（NLR）联合N末端B型利钠肽前体（NT-proBNP）对持续心房颤动射频消融术后早期复发的预测价值。方法　回顾性选取2019年10月至2022年5月期间聊城市第二人民医院收治的102例持续心房颤动射频消融术后患者为研究对象，统计住院1个月持续心房颤动射频消融术后患者的早期复发情况。根据是否早期复发分为复发组与未复发组，对比两组患者的临床资料。logistic多因素回归分析影响患者早期复发的因素，分析NLR、NT-proBNP预测患者早期复发的价值。采用t检验、χ²检验、Fisher确切概率法进行数据分析。结果　持续心房颤动射频消融术后患者早期复发16例，复发率为15.69%。两组性别、年龄、糖尿病、高血压、脑卒中、饮酒、吸烟、高血脂、血清白蛋白、肿瘤坏死因子-α（TNF-α）比较，差异均无统计学意义（均P>0.05）；复发组患者NLR为（9.25±1.52）、NT-proBNP为（902.52±109.25）ng/L，未复发组分别为（5.36±1.21）、（278.52±20.58）ng/L，两组比较，差异均有统计学意义（均P<0.05）。以NLR、NT-proBNP为自变量（均为连续变量），患者住院期间是否未复发为因变量，复发=1，未复发=0，进行logistic回归分析，结果显示，NLR、NT-proBNP均为影响持续心房颤动射频消融术后早期复发的危险因素（均P<0.05）。受试者工作特征曲线（ROC）分析显示，NLR联合NT-proBNP预测持续心房颤动射频消融术后患者复发的灵敏度为72.73%，特异度为97.70%，曲线下面积（AUC）为0.884。NLR联合NT-proBNP预测持续心房颤动射频消融术后复发的特异度和AUC高于单一预测（P<0.05）。结论　NLR、NT-proBNP预测持续心房颤动射频消融术后复发的效能高，但联合预测价值更高。

关键词:

心房颤动, 中性粒细胞/淋巴细胞比值, N末端B型利钠肽前体, 预测价值, 特异度