心房颤动射频消融患者血浆脑钠肽水平的变化及临床价值  

Plasma NT-proBNP level change and its clinical value in patients with atrial fibrillation after radiofrequency catheter ablation

作　　者：贺勇[1] 王晶[1] 贾锋鹏[2] 王新[3] 

机构地区：[1]重庆医科大学附属永川医院检验科,重庆永川402160 [2]重庆医科大学附属第一医院心内科,重庆永川402160 [3]重庆医科大学附属永川医院网络医学部,重庆永川402160

出　　处：《重庆医学》2013年第14期1585-1588,共4页Chongqing medicine

摘　　要：目的探讨无器质性心脏病的心房颤动(简称房颤)患者,导管射频消融(RFCA)前、后氨基末端脑钠肽前体(NT-proBNP)的变化规律性,以及对房颤RFCA术后6个月内复发的预测价值。方法对105例无器质性心脏病心功能正常的房颤患者,根据房颤发作类型不同分为两组:阵发性房颤组(64例)和持续性房颤组(41例)。分别检测两组术前24h、术后3d及术后3个月时NT-proBNP的水平,以及超声心动图检测左心房内径等参数。比较两组患者间消融前、后NT-proBNP水平的变化,以及NT-proBNP是否与术后6个月内房颤复发有相关性。结果术前持续性房颤组患者NT-proBNP水平较阵发性房颤组患者高[(842.09±197.31)pg/mL vs.(658.35±202.45)pg/mL,P=0.040]。阵发性房颤组患者术后3dNT-proBNP水平较术前、术后3个月有下降,但差异无统计学意义(P=0.060)。持续性房颤组患者,术后3dNT-proBNP水平较术前和术后3个月显著降低(P=0.040),术后3个月与术前基线相比有降低,但差异无统计学意义(P=0.420)。随访6个月阵发性房颤组有15例(23.44%)出现复发,持续性房颤组有12例(29.27%)出现复发,两组中房颤复发患者基线NT-proBNP水平均高于未发生房颤复发患者。进一步多因素分析显示,术前NT-proBNP水平(P=0.048)以及左心房内径(P=0.049)是房颤复发的独立预测因素。结论无器质性心脏病心功能正常的房颤患者,房颤射频消融术后3dNT-proBNP水平呈下降趋势,以持续性房颤患者最为显著,术前较高的基线NT-proBNP水平及左心房内径可作为预测房颤射频消融术后6个月内复发的指标。Objective To investigate the change regularity of plasma N-terminal fragment pro-brain natriuretic peptide（NT-proBNP） levels before and after radiofrequency catheter ablation（RFCA） in atiral fibrillation（AF） without organic heart disease and its prediction value of AF recurrence within 6 months after RFCA.Methods 105 of AF without organic heart disease and with normal heart function were divided into the paroxysmal AF group（64 cases） and the persistent AF group（41 cases） according to the different attack types.The NT-proBNP levels were detected at preoperative 24 h and postoperative 3 d and 3 months.Left atrial diameter and left ventricular systolic function were also assessed.6-month follow-up was performed.The recurrence rate of fast atrial arrhythmia was monitored by the dynamic electrocardiogram.The levels NT-proBNP before and after RFCA were compared between the two groups.The correlation of NT-proBNP level with the AF recurrence within 6 months after RFCA was investigated.Results The preoperative NT-proBNP level in the persistent AF group was higher than that in the paroxysmal AF group[（842.09±197.31） pg/mL vs.（658.35±202.45）pg/mL,P=0.040].The NT-proBNP level on postoperative 3 d in the paroxysmal AF group was significantly decreased than that before operation and in postoperative 3 months,difference showing no statistical significance（P=0.060）.TheNT-proBNP level on postoperative 3 d in the persistent AF group was decreased significantly（P=0.040）,whereas which in postoperative 3 months was decreased compared with the preoperative baseline without statistical difference（P=0.420）.during 6-month follow up,15 cases（23.44%） in the paroxysmal AF group and 12 cases（29.27%） in the persistent AF group had AF recurrence.The base line NT-proBNP level in AF recurrence was higher than that without AF recurrence in both two groups.Further multifactors analysis showed that the preoperative NT-proBNP level（P=0.048） and the left atrial diameter（P=0.049） were the inde

关 键 词：心房颤动 氨基末端脑钠肽前体 射频消融 复发 

分 类 号：R541.75[医药卫生—心血管疾病]