中文摘要：

目的：探讨中性粒细胞与淋巴细胞比例和孤立性心房颤动（房颤）射频消融术后复发的关系。方法：回顾分析119例行射频消融术治疗的孤立性房颤患者,阵发性房颤手术方式为环肺静脉电隔离,非阵发性房颤在环肺静脉电隔离基础上行线性消融,收集患者基本的临床资料、生化及物理检查指标。依据随访结果将患者分为复发组与未复发组,分析预测心律失常复发的相关危险因素。结果：随访14~27个月,平均（15.4±3.5）个月。共有38例（31.9%）复发。单因素分析显示,P〈0.1的指标有非阵发性房颤、左房前后径（LAD）、左房容积指数（LAVI）、房颤持续时间、三酰甘油、中性粒细胞与淋巴细胞比值（NLR）。对以上指标进行二分类反应变量的Logistic回归分析,结果显示,LAVI（OR=1.102,95%CI：1.017~1.195,P=0.018）、NLR（OR=4.433,95%CI：1.863~10.546,P=0.001）以及房颤持续时间（OR=1.019,95%CI：1.000~1.038,P=0.046）具有统计学意义。ROC曲线分析显示,LAD的界值点为40.5mm,LAVI的界值点为26.3ml/m2,NLR的界值点为1.64,房颤持续时间的界值点为11.4个月。Kaplan-Meier生存曲线显示,LAD≥40.5mm组与LAD〈40.5mm组（35.3%︰81.2%）、LAVI≥26.3ml/m^2组与LAVI〈26.3ml/m^2组（60.8%︰77.9%）、房颤持续时间≥11.4个月组与〈11.4个月组（46.2%︰94.8%）、NLR≥1.64组与NLR〈1.64组（52.9%︰79.4%）消融成功率比较均差异有统计学意义（均P〈0.05）。结论：LAD、LAVI、NLR、房颤持续时间是孤立性房颤射频消融术后房颤复发的独立危险因素,当LAD≥40.5mm、LAVI≥26.3ml/m^2、NLR≥1.64,房颤持续时间≥11.4个月时,复发的概率明显增加。

英文摘要：

Objective：To investigate whether neutrophil/lymphocyte ratio（NLR）could predicts lone atrial fibrillation（LAF）recurence after radiofrequency catheter ablation（RFCA）.Method：A total of 119 patients with LAF after RFCA were enrolled.Bilateral circumferential pulmonary vein isolation（CPVI）was performed in paroxysmal atrial fibrillation（PAF）,and CPVI combined with linear ablation was performed in non-PAF.The basic clinical data,biochemical and physical examination indicators were collected.Patients were divided into recurrent group and non-recurrent group according to follow-up results.Risk factors associated with arrhythmia recurrence were analyzed.Result：All patients were followed up for 14-27 months with an average of 15.4 ± 3.5months.Thirty-eight patients（31.9%）recurred.The single factor analysis showed that parameters with P value〈0.1were non-PAF,LAD,LAVI,AF duration time,TG and NLR.These above factors were included into binary Logistic regression analysis and the result showed statistical significances in LAVI（OR=1.102,95%CI：1.017-1.195,P=0.018）,NLR（OR=4.433,95%CI：1.863-10.546,P=0.001）（OR=1.019,95%CI：1.000-1.038,P=0.046）.The Roc cutoff point of LAD was 40.5mm,LAVI was 26.3,AF duration was 11.4months,and NLR was 1.64.Kaplan-Meier analysis showed statistically significant differences in LAD≥40.5mm and LAD〈40.5mm（35.3% vs 81.2%）,LAVI≥26.3ml/m^2 and LAVI26.3ml/m^2（60.8% vs 77.9%）,AF duration≥11.4months and AF duration〈11.4 months（46.2% vs 94.8%）,NLR≥1.64 and NLR〈1.64（52.9% vs79.4%）（all P〈0.05）.Conclusion：LAVI,LAD,AF duration time and NLR are independent risk factors thatcould predicted the recurrence of LAF after RFCA.When LAD≥40.5mm,LAVI≥26.3ml/m^2,AF duration≥11.4months and NLR≥1.64,the recurrent rate may be significantly increased.