血浆C反应蛋白浓度、心率和血压变异性联合预测原发性高血压患者并发心房颤动的价值  

Value of combination of plasma concentration of C reactive protein,heart rate and blood pressure in predicting patients with hypertension combined with atrial fibrillation

作　　者：王海林[1] 吴樱[2] 吴其华[1] 卢红艳[1] WANG Hai-lin;WU Ying;WU Qi-hua;LU Hong-yan(Department of Cardiology,Guangning People′s Hospital,Zhaoqing,Guangdong 526300,China;Departmentof Cardiology,Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangdong Academy of MedicalSciences,Guangzhou 510100,China)

机构地区：[1]广宁县人民医院心内科,广东肇庆526300 [2]广东省心血管病研究所心内科广东省人民医院(广东省医学科学院),广州510100

出　　处：《岭南心血管病杂志》2018年第3期318-321,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨血浆C反应蛋白(C reactive protein,CRP)浓度、心率(heart rate,HR)和血压变异性(blood pressure variability,BPV)联合预测原发性高血压(高血压)患者并发心房颤动(房颤)的价值。方法以初治高血压患者120例为研究对象,入选次日对其血浆CRP浓度、HR、BPV、左心室射血分数(left ventricular ejection fraction,LVEF)等进行检测评估,患者均随访1年,统计其随访期间房颤发生率。比较随访期间并发房颤和无房颤患者的血浆CRP浓度、HR、BPV和LVEF,分析高血压患者血浆CRP浓度、HR、BPV与LVEF和房颤发生率的关系,并采用受试者工作特征曲线(receiver operator characteristic curve,ROC)分析血浆CRP浓度、HR、BPV联合预测高血压患者并发房颤的价值。结果高血压患者随访1年房颤发生率为35.83%(43/120)。与无房颤的高血压患者比较,高血压并发房颤患者的血浆CRP浓度和白天、夜间、24 h的舒张压变异性(d DSD、n DSD、24DSD)及白天、夜间、24 h收缩压变异性(d SSD、n SSD、24SSD)等BPV指标和HR均升高,LVEF则降低,差异有统计学意义(P<0.05)。Spearman无条件相关分析结果显示,高血压患者血浆CRP浓度、HR、BPV与LVEF均呈负相关(r=-0.712,-0.848,-0.819,P<0.05);血浆CRP浓度、HR、BPV与房颤发生率则呈正相关(r=0.844,0.878,0.835,P<0.05)。ROC分析结果显示,血浆CRP浓度、HR、BPV联合预测高血压患者并发房颤的价值均良好。结论血浆CRP浓度、心率和血压变异性与心功能和房颤均密切相关且其联合预测房颤的价值良好,可作为高血压并发房颤评估的参考指标。Objectives To investigate the value of combination of plasma concentration of C reactive protein（CRP）,heart rate（HR）and blood pressure variability（BPV）in predicting patients with hypertension combined with atrialfibrillation. Methods Totally 120 patients with primary hypertension and had initial treatment were selected as theresearch objects. Plasma concentration of CRP and HR,BPV,left ventricular ejection fraction（LVEF）of the patientswere examined the next day after selection. The patients were followed up for 1 years,and incidence of atrial fibrillationin the patients during follow-up was statistically analyzed. Plasma concentration of CRP and HR,BPV LVEF inhypertension patients with or without atrial fibrillation were compared. Relationships between plasma concentration ofCRP,HR,BPV,LVEF and incidence of atrial fibrillation were analyzed. Value of plasma concentration of CRP,HR,BPV in predicting patients with hypertension combined with atrial fibrillation were analyzed by receiver operatingcharacteristic curve（ROC）. Results Incidence of atrial fibrillation of 1 years follow-up in patients with hypertensionwas 35.83%（43/120）. Plasma concentration of CRP,HR and day,night,24 h diastolic（dDSD,nDSD,24DSD） and day,night,24 h systolic（dSSD,nSSD,24SSD）BPV indexes of hypertension patients with atrial fibrillation weresignificantly higher than those of hypertension patients without atrial fibrillation,while LVEF of hypertension patientswith atrial fibrillation was lower （P〈0.05）. Spearman unconditional correlation analysis showed that plasmaconcentration of CRP,HR,BPV in patients with hypertension negatively correlated with LVEF（r=-0.712,-0.848,-0.819;P〈0.05）,while they positively correlated with atrial fibrillation（r=0.844,0.878,0.835;P〈0.05）. ROCanalysis showed that value of plasma concentration of CRP,HR,BPV combination in predicting patients withhypertension combined with atrial fibrillation was high. Conclusions Plasma concentrations of CRP,HR,BPV inpatients with hy

关 键 词：高血压 C反应蛋白 心率 血压变异性 联合 预测 心房颤动 

分 类 号：R544.1[医药卫生—心血管疾病]