急性心肌梗死后并发心房颤动患者RDW、ET及NT-proBNP水平变化及其与预后的关系  

Relationship Between the Prognosis and RDW,ET and Change of NT-proBNP Level in Patients with Atrial Fibrillation After Acute Myocardial Infarction

作　　者：赵越超[1] 刘少奎[1] 王筱梅[1] ZHAO Yue-chao;LIU Shao-kui;WANG Xiao-mei(Department of Circulation,Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院循环一科,辽宁大连116001

出　　处：《标记免疫分析与临床》2019年第2期220-224,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨急性心肌梗死后并发心房颤动患者红细胞分布宽度(RDW)、内皮素(ET)及N末端B型脑钠肽前体(NT-proBNP)水平变化及其与预后的关系。方法回顾性分析2016年3月至2018年3月本院收治的106例急性心肌梗死患者[依据患者是否并发心房颤动分为并发组(n=40)及未并发组(n=66)]的临床资料,比较两组临床资料、RDW、ET、NT-proBNP水平及预后情况,分析急性心肌梗死后并发心房颤动及其预后与RDW、ET及NT-proBNP水平的关系。结果并发组TC、左心房内径较未并发组明显扩大,左心室射血分数较未并发组明显降低,并发组RDW、ET及NT-proBNP、不良心血管事件发生率较未并发组明显升高,差异有统计学意义(P <0. 05);未发生心血管事件组LDLC、RDW、ET及NTproBNP较发生心血管事件组明显降低,差异有统计学意义(P <0. 05); RDW、ET及NT-proBNP是急性心肌梗死患者不良心血管事件发生的影响因子(OR=2.591、2.220、1.657,95%CI=1.311～5.153、1.132～4.350、1.058～2.027,P<0.05);急性心肌梗死患者左心房内径与RDW、ET及NT-proBNP呈明显正相关(P<0.05),左心室射血分数与RDW、ET及NTproBNP呈明显负相关(P<0.05)。结论急性心肌梗死后并发心房颤动及其不良预后发生与RDW、ET及NT-proBNP水平升高密切相关,三者在评估急性心肌梗死患者心房颤动及预后中有一定临床意义。Objective To investigate the relationship between the prognosis and red blood cell distribution width (RDW),endothelin (ET)and the changes of N-terminal B-brain natriuretic peptide (NT-proBNP)level in patients with atrial fibrillation after acute myocardial infarction. Methods Data from 106 patients with acute myocardial infarction in our hospital from March,2016 to March,2018 (divided into the concurrent group (n=40)and the non-concurrent group (n=66)according to whether patients with atrial fibrillation)were analyzed. The clinical data,RDW,ET,NT-proBNP level and prognosis were compared between the two groups. The relationship between atrial fibrillation after acute myocardial infarction and prognosis,RDW,ET and NT-proBNP level were analyzed. Results The TC and left atrial diameter of the concurrent group were significantly larger than those of the non-concurrent group,and the left ventricular ejection fraction was significantly lower than that of the non-concurrent group,also,the RDW,ET,NT-proBNP and incidence of adverse cardiovascular events was significantly higher in the concurrent group than that of the non-concurrent group( P <0.05). The LDLC,RDW,ET and NT-proBNP level in the non-cardiovascular event group were significantly lower than those in the cardiovascular event group ( P <0.05). RDW,ET and NT-proBNP level were all influencing factors of adverse cardiovascular events in patients with infarction ( OR =2.591,2.220,1.657,95% CI =1.311-5.153,1.132-4.350,1.058-2.027, P <0.05);there was a significant positive correlation between left atrial diameter in patients with acute myocardial infarction and RDW,ET and NT-proBNP level ( P <0.05),and left ventricular ejection fraction was significantly negatively correlated with RDW,ET and NT-proBNP level ( P <0.05). Conclusion Atrial fibrillation after acute myocardial infarction and its poor prognosis are closely related to the increase of RDW,ET and NT-proBNP level. The three indexes have certain clinical significance in evaluating atrial fibrillation in patients

关 键 词：急性心肌梗死 心房颤动 RDW ET NT-PROBNP 预后 

分 类 号：R542.22[医药卫生—心血管疾病] R541.75[医药卫生—内科学]