血浆尿酸、心房利尿钠肽、内皮素-1水平对急性ST段抬高型心肌梗死并发房颤的预测研究  

Prediction research of the levels of plasma uric acid,atrial natriuretic peptide,and endothelin-1 with acute ST segment elevation myocardial infarction complicated with atrial fibrillation

作　　者：赵小辉[1] 卢双动 陈杰[1] 徐阳[1] 王会哲 ZHAO Xiaohui;LU Shuangdong;CHEN Jie;XU Yang;WANG Huizhe(Department of Emergency,the Second Central Hospital of Baoding,Hebei Province,Baoding 072750,China)

机构地区：[1]河北省保定市第二中心医院急诊科,河北保定072750

出　　处：《中国医药导报》2022年第11期73-76,共4页China Medical Herald

基　　金：河北省医学科学研究课题计划项目(20200263)。

摘　　要：目的分析血浆尿酸(UA)、心房利尿钠肽(ANP)、内皮素-1(ET-1)水平对急性ST段抬高型心肌梗死(STEMI)并发心房颤动(以下简称“房颤”)的预测价值。方法选取河北省保定市第二中心医院2019年1月至2020年5月收治的156例初诊STEMI患者实施常规治疗和随访,统计房颤发生率,并根据是否并发房颤分为并发组和未并发组。分析患者并发房颤的危险因素、各指标单独及联合对患者并发房颤的预测价值。结果发生组年龄、体重指数(BMI)、合并缺血性脑血管病、合并糖尿病、合并高血压、合并高脂血症、初诊左房内径>50 mm、心功能Killip分级>Ⅱ级、初诊糖类抗原(CA)125水平、初诊UA水平、初诊ANP水平、初诊ET-1水平、未遵医嘱治疗占比均高于未发生组(P<0.05)。年龄、BMI、合并缺血性脑血管病、合并糖尿病、合并高血压、合并高脂血症、初诊左房内径>50 mm、心功能Killip分级>Ⅱ级、初诊CA125水平、初诊UA水平、初诊ANP水平、初诊ET-1水平、未遵医嘱治疗均是患者并发房颤的危险因素(R>1,P<0.05)。受试者操作特征曲线结果显示联合预测的曲线下面积高于单独预测(Z=3.867,P=0.001;Z=2.838,P=0.005;Z=2.650,P=0.008)。结论血浆UA、ANP、ET-1水平与年龄、BMI均是并发房颤的危险因素,且三者联合预测并发房颤的效能较单独指标更高。Objective To analyze the predictive value of the levels of plasma uric acid(UA),atrial natriuretic peptide(ANP),and endothelin-1(ET-1)with acute ST segment elevation myocardial infarction(STEMI)complicated with atrial fibrillation.Methods A total of 156 newly diagnosed STEMI patients admitted to the Second Central Hospital of Baoding from January 2019 to may 2020 were selected for routine treatment and follow-up,and the incidence of atrial fibrillation was counted,and divided into concurrent group and non concurrent group according to whether complicated or not atrial fibrillation.The predictive value of the risk factors,each index alone,and in combination for patients with atrial fibrillation were analyzed.Results Age,body mass index(BMI),complication of ischemic cerebrovascular disease,complication of diabetes,complication of hypertension,complication of hyperlipidemia,left atrial diameter>50 mm at initial diagnosis,cardiac function Killip classification>Ⅱ grade,newly diagnosed carbohydrate antigen(CA)125 level,newly diagnosed UA level,newly diagnosed ANP level,newly diagnosed ET-1 level,and non-compliance with medical advice in the occurrence group were higher than those in the non-occurrence group(P<0.05).Age,BMI,complication of ischemic cerebrovascular disease,complication of diabetes,complication of hypertension,complication of hyperlipidemia,left atrial diameter>50 mm at initial diagnosis,cardiac function Killip classification>Ⅱ grade,newly diagnosed CA125 level,newly diagnosed UA level,newly diagnosed ANP level,newly diagnosed ET-1 level,and non-compliance with medical advice were all risk factors for patients with atrial fibrillation(R>1,P<0.05).Receiver operating characteristic curve showed that the area under the curve of joint prediction was higher than that of separate prediction(Z=3.867,P=0.001;Z=2.838,P=0.005;Z=2.650,P=0.008).Conclusion The plasma levels of UA,ANP,ET-1,and age,BMI are all risk factors of atrial fibrillation,and the combination of the three indicators are more effective in predi

关 键 词：尿酸 心房利尿钠肽 内皮素-1 急性ST段抬高型心肌梗死 心房颤动 

分 类 号：R542.2[医药卫生—心血管疾病]