术前血浆N-末端脑钠肽前体浓度与瓣膜置换同期射频消融术后心房颤动复发的关系  

The relationship between preoperative plasma N-terminal pro-brain natriuretic peptide and recurrence of atrial fibrillation after cardiac valve replacement combined with radiofrequency ablation

作　　者：孙伟[1] 宋兵[1] 程殿威[1] 柳德斌[1] 

机构地区：[1]兰州大学第一医院心血管外科,730000

出　　处：《中国医师进修杂志》2012年第26期11-13,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨术前血浆N-末端脑钠肽前体（NT-proBNP）浓度与瓣膜置换同期射频消融术后心房颤动复发的关系。方法58例心脏瓣膜病合并心房颤动患者，行瓣膜置换同期射频消融术，根据患者术后3个月内心房颤动是否复发将患者分为心房颤动复发组（18例）和心房颤动未复发组（40例），两组患者分别于术前1d和术后9d采用放射免疫法检测血浆NT-proBNP浓度。结果心房颤动复发组术前Id血浆NT-proBNP浓度（中位数为2061.30ng／L）明显高于心房颤动未复发组（中位数为579．00ng／L）（P〈0．01）；心房颤动复发组术后9d血浆NT-proBNP浓度（中位数为996．60ng／L）显著高于心房颤动未复发组（中位数为209．20ng／L）（P〈0．01）；且两组患者术前1d血浆NT-proBNP浓度均高于术后9d（P〈0．01）。结论术前血浆NT．proBNP浓度与瓣膜置换同期射频消融术后心房颤动的复发有一定的关系，对预测心房颤动的复发具有一定的临床应用价值。Objective To explore the relationship between preoperative plasma N-terminal pro-brain natriuretie peptide （NT-proBNP） and recurrence of atrial fibrillation （AF） after cardiac valve replacement （CVR） combined with radiofrequency ablation. Methods Fifty-eight patients with AF undergoing CVR combined with radiofrequency modified Maze procedure were enrolled in this study. The patients were allocated to either AF recurrence group （AF group, 18 cases） or AF no recurrence group （SR group, 40 cases） according to whether patient＇s AF recurrence or not within 3 months after surgery. NT-proBNP were respectively measured in two groups in 1st day before operation and 9th day after operation by radioimmunoassay. Results All the 58 patients were involved in the final analysis. NT-proBNP levels in 1st day before operation and 9th day after operation in AF group was significantly higher than that in SR group （2061.30 ng/L vs. 579.00 ng/L, 996.60 ng/L vs. 209.20 ng/L,P 〈 0.01 ）. NT-proBNP levels in 1st day before operation in two groups was significantly higher than that in 9th day after operation （P 〈 0.01 ）. Conclusions There is a good relationship between preoperative plasma NT-proBNP levels and recurrence of AF. It has a clinical value in predicting of recurrence AF after CVR combined with radiofrequency modified Maze procedure.

关 键 词：心脏瓣膜假体植入 导管消融术 心房颤动 N-末端脑钠肽前体 

分 类 号：R654.2[医药卫生—外科学] R541.75[医药卫生—临床医学]