同型半胱氨酸、脑钠肽与阵发性心房颤动患者复律的临床分析  

Effect of homocysteine and brain natriuretic peptide on cardioversion in patients with paroxysmal atrial fibrillation

作　　者：罗溶 谢建芳 孙晓臣 王韦 汪自龙 刘海波 LUO Rong;XIE Jianfang;SUN Xiaochen;WANG Wei;WANG Zilong;LIU Haibo(Department of Cardiology,Qingpu Medical Center,Zhongshan Hospital,Fudan University,Shanghai 201700,China)

机构地区：[1]复旦大学附属中山医院青浦分院心内科,上海201700

出　　处：《上海医学》2021年第8期580-582,共3页Shanghai Medical Journal

基　　金：上海市卫生健康委员会先进适宜技术推广项目(2019SY010);上海市中西医结合学会科研基金(SQ45)。

摘　　要：目的探讨同型半胱氨酸(Hcy)、脑钠肽(BNP)对阵发性心房颤动(简称房颤)患者复律的影响。方法回顾性分析2017年1月-2019年12月在复旦大学附属中山医院青浦分院心内科治疗的150例阵发性房颤(房颤持续时间≤48 h)患者的临床资料。依据复律成功与否分为复律成功组、复律失败组,选取同期无房颤病史的窦性心律患者50例为对照组。比较3组间年龄、性别、病史、ACEI或ARB服药情况、实验室检查结果,以及超声心动图各项指标的差异。采用多因素logistic回归分析复律成功的影响因素。结果3组患者的年龄,性别构成,合并高血压、糖尿病、基础心脏病患者比例的差异均无统计学意义(P值均>0.05)。与对照组相比,复律成功组Hcy、BNP水平较高,心室率较快,左心房内径(LAD)较大,差异均有统计学意义(P值均<0.05)。与复律成功组相比,复律失败组患者Hcy、BNP水平较高,LAD较大,差异均有统计学意义(P值均<0.05),复律成功组与复律失败组间心室率的差异无统计学意义(P>0.05)。多因素logistic回归分析显示,LAD(OR=1.312,95%CI为1.171~1.985)、Hcy(OR=1.975,95%CI为1.217~3.862)、BNP(OR=1.348,95%CI为1.261~1.715)与房颤复律相关(P值均<0.01)。结论LAD增大、Hcy、BNP水平升高是影响阵发性房颤患者复律的危险因素。Objective To explore the effect of homocysteine(Hcy)and brain natriuretic peptide(BNP)levels on cardioversion in patients with paroxysmal atrial fibrillation(AF).Methods Clinical data of 150 patients with paroxysmal AF(AF duration≤48 h)admitted to our hospital from January 2017 to December 2019 were retrospectively analyzed in this study.They were divided into successful group and failed group according to the cardioversion result.Meanwhile,50 sinus rhythm patients without AF history were assigned to control group.Age,gender,medical history,drug use(such as ACEI and ARB),laboratory examination results,and indicators of echocardiogram were compared among groups.Multivariate logistic regression analysis was used to analyze influencing factors of cardioversion.Results There was no significant difference in age,gender,history of hypertension,history of diabetes mellitus,or history of basic heart disease between groups(all P>0.05).Hcy,BNP,ventricular rate,left atrial diameter(LAD)in the successful cardioversion group were significantly higher than those in the control group(all P<0.05).The levels of Hcy,BNP and LAD in the failed cardioversion group were significantly higher than those in the successful cardioversion group(all P<0.05).Multivariate logistic regression analysis showed that LAD(OR=1.312,95%CI:1.171-1.985),Hcy(OR=1.975,95%CI:1.217-3.862)and BNP(OR=1.348,95%CI:1.261-1.715)were correlated with AF recovery(all P<0.05).Conclusion Increased LAD,Hcy and BNP are risk factors of cardioversion in patients with paroxysmal AF.

关 键 词：心房颤动 心律转变法 左心房内径 同型半胱氨酸 脑钠肽 

分 类 号：R541.75[医药卫生—心血管疾病]