术前左房内径及血清脑钠肽水平对心房颤动患者射频消融术后复发的预测价值  

Predictive value of preoperative left atrial diameter and serum brain natriuretic peptide level in patients with atrial fibrillation after radiofrequency ablation

作　　者：汤泽生[1] 陈磊[2] 张桂[3] 崔亭亭 Ze-sheng Tang;Lei Chen;Gui Zhang;Ting-ting Cui(Department of Cardiology, Taizhou Traditional Chinese Medicine Hospital, Taizhou, Zhejiang 318000 China;Department of Cardiology, Taizhou Central Hospital, Taizhou, Zhejiang 318000 China;Laboratory Medicine, Taizhou Traditional Chinese Medicine Hospital, Taizhou, Zhejiang 318000 China;Color Ultrasonic Room, Taizhou Traditional Chinese Medicine Hospital, Taizhou, Zhejiang 318000 China)

机构地区：[1]台州市中医院心内科,浙江台州318000 [2]台州市中心医院心内科,浙江台州318000 [3]台州市中医院检验科,浙江台州318000 [4]台州市中医院彩超室,浙江台州318000

出　　处：《中国现代医学杂志》2019年第15期112-116,共5页China Journal of Modern Medicine

摘　　要：目的探讨左房内径(LAD)及血清脑钠肽(BNP)水平对心房颤动(AF)患者射频消融术后复发的预测价值。方法选取2017年1月-2018年1月台州市中医院心内科收治的80例AF患者,设为观察组,均采用射频消融术治疗,同期选取76例健康人群作为对照组。比较两组患者左室射血分数(LVEF)、LAD、血清BNP、高敏C反应蛋白(hs-CRP)及血管紧张素转化酶(ACE),分析AF相关因素,同时对观察组患者建立受试者操作特征(ROC)曲线,分析LAD及血清BNP对AF患者复发的预测价值。结果观察组患者慢性阻塞性肺疾病、肺动脉高压、冠状动脉粥样硬化性心脏病(以下简称冠心病)及高血压发生率与对照组比较,差异有统计学意义(P<0.05),观察组高于对照组。观察组患者血清hs-CRP、BNP、ACE水平及LAD与对照组比较,差异有统计学意义(P<0.05),观察组高于对照组。扩张型心肌病、慢性阻塞性肺疾病、肺动脉高压、冠心病、高血压、hs-CRP、BNP、ACE水平及LAD与AF呈正相关(P<0.05)。LAD预测AF复发的ROC曲线下面积为0.693,血清BNP水平预测AF复发ROC曲线下面积为0.690。结论 AF发生与多种因素相关,AF患者射频消融术后复发能够通过术前血清BNP水平及LAD进行预测。Objective To study the predictive value of preoperative left atrial diameter and serum brain natriuretic peptide level in patients with atrial fibrillation after radiofrequency ablation. Methods From January2017 to January 2018, 80 patients with atrial fibrillation were retrospectively analyzed. All patients were treated with radiofrequency ablation. Totally 76 healthy people were selected as control group during the same period. Left ventricular ejection fraction(LVEF), LAD, serum BNP, high-sensitivity C-reactive protein(hs-CRP) and angiotensinconverting enzyme(ACE) were compared between the two groups. AF-related factors were analyzed and subjects were established in the observation group. The operating characteristic(ROC) curve was used to analyze the predictive value of LAD and serum BNP for recurrence in AF patients. Results In the observation group, the incidence of chronic obstructive pulmonary disease, pulmonary hypertension, coronary atherosclerotic heart disease(hereinafter referred to as coronary heart disease) and hypertension was significantly higher than that of the control group(P < 0.05). The serum hs-CRP, BNP, ACE levels and LAD of the observation group were significantly higher than those of the control group(P < 0.05). Age, dilated cardiomyopathy, chronic obstructive pulmonary disease, pulmonary hypertension, coronary heart disease, hypertension, hs-CRP, BNP, ACE levels, and LAD were positively correlated with AF(P < 0.05).LAD predicted the area under the ROC curve of AF recurrence to be0.693, and the serum BNP level predicted the area under the ROC curve of AF recurrence was 0.690. Conclusions AF is associated with multiple factors. Recurrence after radiofrequency ablation in AF patients can be predicted by preoperative serum BNP levels and LAD.

关 键 词：左房内径/心房 脑钠肽/利钠肽 脑 心房颤动 危险因素 预测 

分 类 号：R541[医药卫生—心血管疾病]