心房颤动患者氨基末端脑钠肽前体水平与左心房大小的临床研究  

Relationship between plasma N-terminal pro-brain natriuretic peptide level and left atrial diameter in patients with atrial fibrillation

作　　者：汤长春[1] 张翼[1] 胡美英[1] 彭珍云[1] 曾向辉[1] 

机构地区：[1]湖南师范大学第一附属医院心内科,长沙410005

出　　处：《中国心血管杂志》2011年第1期16-18,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨左心室收缩功能正常的心房颤动患者血清氨基末端脑钠肽前体(NT-proBNP)水平与左心房内径(LAD)的关系及临床意义。方法选取左心收缩功能正常的阵发性心房颤动患者31例、持续性心房颤动患者30例和永久性心房颤动患者33例,另选30名窦性心律者为对照组,比较不同类型心房颤动患者与窦性心律者血清NT-proBNP水平,并观察血清NT-proBNP水平与LAD大小的关联。结果心房颤动患者血清NT-proBNP水平较窦性心律者升高,差异有统计学意义[(305.2±170.9)ng/L比(57.2±31.9)ng/L,P<0.01]。其中持续性心房颤动组的LAD和NT-proBNP较阵发性心房颤动组均显著升高[LAD:(33.7±4.9)mm比(30.5±3.3)mm,P<0.05;NT-proBNP:(261.8±124.9)ng/L比(143.7±26.2)ng/L,P<0.05];永久性心房颤动组的LAD和NT-proBNP较阵发性心房颤动组均显著升高[LAD:(37.5±2.9)mm比(30.5±3.3)mm,P<0.05;NT-proBNP:(599.0±33.5)ng/L比(143.7±26.2)ng/L,P<0.05];永久性心房颤动组的LAD和NT-proBNP较持续性心房颤动组均显著升高[LAD:(37.5±2.9)mm比(33.7±4.9)mm,P<0.05;NT-proBNP:(599.0±33.5)ng/L比(261.8±124.9)ng/L,P<0.05]。不同类型心房颤动组的LAD越大(中位值分别为30.5、33.7和37.5 mm),患者血清NT-proBNP的水平越高(中位值分别为143.7ng/L、261.8ng/L和599.0 ng/L)多元线性逐步回归分析显示,LAD、心房颤动类型和病程是高血清NT-proBNP水平的独立预测因素(均为P<0.01)。结论在左心室收缩功能正常的不同类型心房颤动患者中,血清NT-proBNP水平明显高于窦性心律者,可能与患者心房结构重构及心房颤动类型和病程密切相关。Objective To investigate the relationship between plasma N-terminal pro-brain natriuretic peptide （NT-pro-BNP） level and left atrial diameter （LAD） in patients with atrial fibrillation （AF） and normal left ventricular systolic function （LVEF）. Methods A total of 94 patients with paroxysmal （n = 31 ）, persistent （n = 30） or permanent （n = 33） AF and normal LVEF were enrolled in this study. Another 30 patients with sinus rhythm were selected as control group. A written informed consent form was signed by each participant before enrollment. Clinical data were collected and plasma NT-pro-BNP level was measured in all subjects. LAD was measured by transthoracie echocardiography. Results Plasma NT-pro-BNP level was significantly higher in AF patients than in control group [ （305.2±170. 9） ng/L vs. （57.2±31.9） ng/L, P 〈0. 01], especially in permanent AF patients [ （599. 0±33.5 ） ng/L. Patients with permanent AF had significantly greater LAD than persistent or paroxysmal AF patients [ （37.5±2.9） mm vs. （33.7 ±4. 9） mm and （30. 5±3.3） ram, all P 〈0. 05]. Plasma NT-pro-BNP level was positively correlated with I,AD in AF patients. Multiple linear stepwise regression analysis revealed that LAD, type and course of AF were independent predictors of plasma NT- proBNP level （all P 〈0. 01 ）. Conclusions Plasma NT-pro-BNP level is positively correlated with LAD in patients with AF and normal LVEF.

关 键 词：心房颤动 利钠肽 脑 心房功能 左 

分 类 号：R541.75[医药卫生—心血管疾病]