血浆N末端脑钠肽前体预测阵发性心房颤动药物复律效果的价值  

The value of plasma NT-proBNP levels in predicting the effect of drug conversion for paroxysmal atrial fibrillation

作　　者：杨曙光[1] 屈克学[1] 孙晓云[1] 张代民[1] 张杰[1] 苏玉文[1] 

机构地区：[1]88医院心内科,山东泰安271000

出　　处：《实用医药杂志》2009年第12期3-4,7,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨非瓣膜性心脏病阵发性心房颤动(房颤)患者药物复律前血浆N末端脑钠肽前体水平对复律效果的预测价值。方法98例非瓣膜性心脏病阵发性房颤患者接受顿服普罗帕酮450～600mg复律治疗,观察患者复律前后血浆N末端脑钠肽前体(NT-proBNP)水平变化。结果98例阵发性房颤患者顿服普罗帕酮后48h内57例(58.2%)转复为窦性心律,成功复律组患者复律前血浆NT-proBNP水平为(435.65±156.27)ng/L,明显低于未成功复律组的(482.76±59.86)ng/L,(P<0.01),成功复律组患者复律后1h血浆NT-proBNP水平为(195.61±36.38)ng/L,明显低于复律前的(435.65±156.27)ng/L,(P<0.01),而未成功复律组复律前血浆NT-proBNP为(482.76±59.86)ng/L,与服药后48h的(453.76±143.38)ng/L无明显变化(P>0.05)。结论房颤本身是影响心肌细胞脑钠肽分泌的重要因素,入院时血浆NT-proBNP水平对非瓣膜性心脏病阵发性房颤药物复律效果具有预测价值。Objective To investigate the value of plasma NT-proBNP levels in predicting the effect of drug conversion for paroxysmal atrial fibrillation. Method The 98 patients with monvalvular paroxysmal atrial fibrillation were treated by oral loading-dose of propafenon （450-600ng/L） within 1 h after admission. The plasma NT-proBNP concentrations were mearsured before and after conversion therapy. Result Atrial fibrillation was conversed to sinus rhythm in 57 patients（58.2%） after oral loading-dose of propafenone. The plasma NT-proBNP levels before drug conversion in patients with successful conversion were lower than that in patients with non-successful conversion （435.65±156.27）ng/L vs （482.76±59.86） ng/L,P〈0.01; and it was ＇decreased significantly after successful drug conversion （195.61±36.38）ng/L vs （435.65±156.27）ng/L,P〈0.01. There was no significant difference of plasma NT-proBNP concentration before and after propefenone treatment （482.76±59.86）ng/L vs （453.76±143.38）ng/L （P〉0.05） in patients non-conversed to sinus rhythum. Conclusion Atrial fibrillation is a significant factor influencing the secretion of BNP in patient with nonvalvular heart disease and plasma NT-proBNP levels can be used as a biomarker to predict the effect of drug conversion for paroxysmal atrial fibrillation.

关 键 词：心房颤动 脑钠肽 N末端脑钠肽前体 药物复律 

分 类 号：R541.7[医药卫生—心血管疾病] R349.5[医药卫生—内科学]