冠心病患者发生心律失常的危险因素及血清hs-CRP、NT-proBNP的评价分析  

Risk factors of arrhythmia and evaluation analysis on serum hs-CRP and NT-proBNP in patients with coronary heart disease

作　　者：谢红梅 廖莲梅 陈文曦 黎婕 Xie Hongmei;Liao Lianmei;Chen Wenxi;Li Jie(Department of Cardiovascular Medicine,People’s Hospital,Liangjiang New District,Chongqing 401121,China)

机构地区：[1]重庆两江新区人民医院心血管内科,重庆401121

出　　处：《中国循证心血管医学杂志》2025年第2期195-198,204,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：重庆市科卫联合医学科研项目(2020FYYX039)。

摘　　要：目的分析冠状动脉粥样硬化性心脏病(冠心病)患者发生心律失常的危险因素,探讨血清超敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-proBNP)对心律失常的评估价值。方法选取2020年5月至2023年5月于重庆两江新区人民医院治疗的145例冠心病患者作为研究对象,根据心律失常发生情况分为:非心律失常组61例和心律失常组84例,分析冠心病患者并发心律失常的危险因素,采用ROC曲线评价hs-CRP、NT-proBNP对心律失常的评估价值。结果单因素分析显示,年龄≥60岁、具有吸烟史、合并高血压、糖尿病、血钾水平<3.5 mmol/L、合并慢性阻塞性肺疾病(COPD)、心绞痛分级为Ⅲ级、未使用β受体阻滞剂患者的心律失常发生率较高(P<0.05)。多因素Logistics回归分析显示,年龄、吸烟史、合并高血压、合并糖尿病、血钾水平、合并COPD、心绞痛分级、β受体阻滞剂均为影响冠心病患者并发心律失常的危险因素(P<0.05)。与非心律失常组比较,心律失常组患者的hs-CRP、NT-proBNP表达水平均升高(P<0.05)。ROC曲线分析显示,与hs-CRP、NT-proBNP单项预测比较,两项联合对心律失常的评估价值较高(P<0.05)。结论年龄、吸烟史、合并高血压、合并糖尿病、血钾水平、合并COPD、心绞痛分级、未使用β受体阻滞剂为冠心病患者并发心律失常的危险因素,血清hs-CRP、NT-proBNP水平对冠心病心律失常的发生均有较高的临床价值。Objective To analyze the risk factors for arrhythmia occurrence,and discuss the evaluation value of serum high sensitivity C-reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)to arrhythmia in patients with coronary heart disease(CHD).Methods CHD patients(n=145)were chosen from People’s Hospital of Liangjiang New District in Chongqing from May 2020 to May 2023.All patients were divided,according to arrhythmia occurrence,into non-arrhythmia group(n=61)and arrhythmia group(n=84).The risk factors for arrhythmia occurrence were analyzed in CHD patients,and evaluation value of serum hs-CRP and NTproBNP to arrhythmia were reviewed by using ROC curve.Results The results of single-factor analysis showed that arrhythmia incidence was higher in patients aged≥60,complicated by smoking history,hypertension and diabetes,with blood potassium level<3.5 mmol/L,complicated by chronic obstructive pulmonary disease(COPD),with gradeⅢof angina pectoris classification and without usedβ-receptor blocker.The results of multi-factor Logistics analysis showed that age,smoking history,complicated by hypertension and diabetes,blood potassium level,complicated by COPD,angina pectoris classification andβ-receptor blocker usage were risk factors for arrhythmia occurrence in CHD patients(P<0.05).The levels of serum hs-CRP and NT-proBNP increased in arrhythmia group compared with non-arrhythmia group(P<0.05).The results of ROC curve analysis showed that the review value of hs-CRP combined with NT-proBNP was higher than that of single hs-CRP or single NT-proBNP in predicting arrhythmia occurrence.Conclusion Age,smoking history,complicated by hypertension and diabetes,blood potassium level,complicated by COPD,angina pectoris classification andβ-receptor blocker usage are risk factors in CHD patients complicated by arrhythmia,and levels of serum hs-CRP and NT-proBNP have a higher predictive value to arrhythmia occurrence in clinical practice.

关 键 词：冠心病 心律失常 超敏C反应蛋白 N末端脑钠肽前体 

分 类 号：R541.4[医药卫生—心血管疾病]