冠状动脉慢血流患者发生心房纤颤与NT-proBNP关系  

Relationship between atrial fibrillation and NT-proBNP in patients with coronary slow flow

作　　者：张林叶[1] 柏战 王宗方[1] 张丙雨[1] 王玮 周志刚 ZHANG Linye;BAI Zhan;WANG Zongfang;ZHANG Bingyu;WANG Wei;ZHOU Zhigang(Department of Cardiology,Wuhu Second People's Hospital,Anhui Province,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市第二人民医院心内科

出　　处：《疑难病杂志》2019年第7期661-664,669,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探究冠状动脉慢血流现象(CSFP)患者并发心房纤颤(AF)与N-末端脑钠肽前体(NT-proBNP)的关系。方法选取2014年1月-2018年6月芜湖市第二人民医院心内科行冠状动脉造影发现CSFP患者79例为CSFP组,根据是否发生AF分为AF亚组26例,非AF亚组53例,同期冠状动脉造影正常患者81例为对照组,比较2组一般临床资料及相关生化指标、超声心动图资料、心率变异性指标(SDNN、SDANN、r-MSSD和PNN50)。结果与对照组相比,CSFP组尿酸、左房内径(LAD)明显增加,而总胆固醇、低密度脂蛋白胆固醇、SDNN、SDANN、PNN50均降低(t/P=2.379/0.019、3.618/0.000、14.148/0.000,2.204/0.045,2.158/0.032,2.411/0.014、2.284/0.027、1.974/0.040)。与非AF亚组相比,AF亚组LAD和Lg(NT-proBNP)水平均升高(t/P=4.522/0.000、7.008/0.000),而左室射血分数、SDNN值均下降(t/P=-4.422/0.000、-4.870/0.000)。多因素回归分析显示Lg(NT-proBNP)是CSFP患者发生AF的独立危险因素(OR=16.412,95%CI 2.317~116.279,P=0.005)。结论CSFP患者房颤发生率显著增加,NT-proBNP水平是CSFP患者发生房颤的独立危险因素。Objective To explore the relationship between atrial fibrillation(AF)and N-terminal brain natriuretic peptide precursor(NT-proBNP)in patients with coronary slow flow phenomenon(CSFP).Methods Seventy-nine patients with CSFP were selected from the Department of Cardiology of Wuhu Second People’s Hospital from January 2014 to June 2018 as CSFP group.According to whether AF occurred,they were divided into AF subgroup(26 cases),non-AF subgroup(53 cases)and normal coronary angiography group(81 cases)as control group.The general clinical data and related biochemical indexes,echocardiogram data and heart rate variability indexes(SDANN,SDANN,rMSSD and PN50)of the two groups were compared.Results Compared with the control group,the uric acid and left atrial diameter(LAD)were significantly increased in the CSFP group,while total cholesterol,low-density lipoprotein cholesterol,SDNN,SDANN,and PNN50 were decreased(t/P=2.379/0.019,t/P=3.618/0.000,t/P=14.148/0.000,t/P=2.204/0.045,t/P=2.158/0.032,t/P=2.411/0.014,t/P=2.284/0.027,t/P=1.974/0.040).Compared with the non-AF subgroup,the AF subgroup had elevated LAD and Lg(NT-proBNP)levels(t/P=4.522/0.000,t/P=7.008/0.000),while the left ventricular ejection fraction and SDNN values were both decrease(t/P=-4.422/0.000,t/P=-4.870/0.000).Multivariate regression analysis showed that Lg(NT-proBNP)was an independent risk factor for AF in CSFP patients(OR=16.412,95%CI 2.317-116.279,P=0.005).Conclusion The incidence of atrial fibrillation in CSFP patients increased significantly.NT-proBNP level was an independent risk factor for atrial fibrillation in CSFP patients.

关 键 词：冠状动脉慢血流现象 心房纤颤 N末端脑钠肽前体 

分 类 号：R541.75[医药卫生—心血管疾病]