血清脑钠肽、高敏C反应蛋白、可溶性生长刺激表达基因2在阵发性心房颤动患者射频消融术后复发中的预测价值  

Prognostic value of serum brain natriuretic peptide,hypersensitive C-reactive protein and soluble ST2 in patients with paroxysmal atrial fibrillation after radiofrequency ablation

作　　者：赵伟伟 葛建敏 王文珊 李雯 褚杰 Zhao Weiwei;Ge Jianmin;Wang Wenshan;Li Wen;Chu Jie(Fourth Department of Cardiology,the First Hospital of Zhangjiakou City,Hebei Province,Zhangjiakou 075000,China)

机构地区：[1]河北省张家口市第一医院心内四科,075000

出　　处：《疑难病杂志》2023年第9期924-928,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：张家口市科研与发展计划项目(1921082D)。

摘　　要：目的分析研究血清脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)、可溶性生长刺激表达基因2(sST2)在阵发性心房颤动(PaAF)患者射频消融术后复发中的预测价值。方法选取2020年1月—2022年1月张家口市第一医院心内四科收治的96例PaAF患者作为研究对象,均进行射频消融术治疗,术后对患者进行1年随访,根据有无房颤复发将患者分为复发组(n=24)与未复发组(n=72)。比较2组的血清BNP、hs-CRP与sST2水平;收集2组患者的临床资料,采用多因素Logistic回归分析PaAF患者射频消融术后房颤复发的影响因素,并绘制受试者工作特征(ROC)曲线,分析血清BNP、hs-CRP与sST2水平对PaAF患者射频消融术后房颤复发的预测价值。结果复发组PaAF患者的血清BNP、hs-CRP与sST2水平均显著高于未复发组,差异均具有统计学意义(t/P=14.916/<0.001、11.974/<0.001、7.229/<0.001);多因素Logistic回归分析显示,有冠心病史、BNP水平升高、hs-CRP水平升高及sST2水平升高均是PaAF患者射频消融术后房颤复发的独立危险因素[OR(95%CI)=1.718(1.200~2.459)、1.891(1.214~2.945)、2.104(1.237~3.579)、1.902(1.243~2.910)];ROC曲线分析显示,血清BNP、hs-CRP与sST2水平及联合检测评估PaAF患者射频消融术后房颤复发的曲线下面积(AUC)分别为0.975、0.965、0.870、0.989,联合检测优于单一检测(Z=2.027、2.309、3.001,均P<0.05)。结论血清BNP、hs-CRP、sST2在PaAF患者射频消融术后复发中呈高表达,对PaAF患者射频消融术后房颤复发具有一定的预测价值。Objective To investigate the predictive value of serum BNP,hs-CRP and soluble growth stimulation expression gene 2(sST2)in patients with paroxysmal atrial fibrillation(PaAF)after radiofofency ablation.Methods A total of 96 PaAF patients admitted to Fourth Department of Cardiology,the First Hospital of Zhangjiakou City from January 2020 to January 2022 were selected as study subjects,all of whom were treated with radiofrequency ablation.The patients were followed up for 1 year after surgery,and were divided into recurrence group(n=24)and non-recurrence group(n=72)according to whether AF recurred.The serum levels of BNP,hs-CRP and sST2 were compared between the two groups.The clinical data of the two groups of patients were collected,and the influencing factors of AF recurrence in PaAF patients after radiofrequency ablation were analyzed by multivariate Logistic regression,and the predictive value of serum BNP,hs-CRP and sST2 levels in atrial fibrillation recurrence in PaAF patients after radiofrequency ablation was analyzed by ROC curve.Results The levels of serum BNP,hsCRP and sST2 in relapsed group were higher than those in non-relapsed group,with statistical significance(t/P=14.916/<0.001,11.974/<0.001,7.229/<0.001).Multivariate Logistic regression analysis showed that History of coronary heart disease,elevated BNP level,elevated hs-CRP level and elevated sST2 level were independent risk fac-tors for atrial fibrillation recurrence in PaAF patients after RF ablation[OR(95%CI)=1.718(1.200-2.459),1.891(1.214-2.945),2.104(1.237-3.579),1.902(1.243-2.910)].ROC curve analysis showed that the level of serum BNP,hs-CRP and sST2 and the area under the curve(AUC)of combined detection to evaluate the recurrence of atrial fibrillation in PaAF patients after RF ablation were 0.975,0.965,0.870 and 0.989,respectively.Combined detection was superior to single detection(Z=2.027,2.309,3.001,P<0.05).Conclusion Serum BNP,hs-CRP and sST2 are highly expressed in the recurrence of atrial fibrillation after radiofrequency ablation in P

关 键 词：阵发性心房颤动 射频消融术 脑钠肽 高敏C-反应蛋白 可溶性生长刺激表达基因2 

分 类 号：R541.7[医药卫生—心血管疾病]