血浆脑利钠肽水平变化与心房纤颤患者预后相关性研究

目的研究在心脏收缩功能正常情况下,血浆脑利钠肽（BNP）水平变化与心房纤颤患者预后相关性。方法 62例心脏收缩功能正常心房纤颤患者,经超声心动图检测后,分为A组：LA〈40mm,B组：LA〉40mm,测定病人在转复前及转复窦性心律后血清BNP的浓度,并随访1年,观察的主要终点为心房颤动复发、脑栓塞及明显心功能不全。结果房颤复律后血浆BNP水平下降,差异有显著性（P〈0.05）,复律后BNP仍显著高于对照组（P〈0.05）;心房颤动复发、脑栓塞及明显心功能不全的风险随BNP升高而升高;左心房内径增大,房颤复发率增高。结论房颤可导致血浆BNP水平升高,复律后BNP水平下降,左心房内径的大小影响心房颤动复律的成功率和BNP水平,BNP在房颤的预测、治疗和预后判断方面有一定的价值。

Study on Realtion Between Changes of Plasma Brain Natriuretic Peptide and Prognosis in Patients with Atrial Fibrillation

Objective To study on the realtion between the changes of plasma brain natriuretic peptide（BNP） and prognosis in atrial fibrillation（AF） patients with normal left ventricle function.Methods The 62 cases of AF patients with normal left ventricle function were divided into two groups after echocardiography：group A（LA40 mm）and group B（LA40mm）.Plasma BNP levels were measured before and after cardioversion.The patients were followed up one year,the primary end point was recurrence of atrial fibrillation,cerebral embolism and obvious cardiac insufficiency.Results After successful cardioversion,plasma BNP levels decreased significantly（P0.05）,BNP in the patients after successful cardioversion was significantly higher than that in the control gorup（P0.05）;the higher plasma BNP levels,the higher risks of recurrence of atrial fibrillation,cerebral embolism and obvious cardiac insufficiency;the diameter of left atrium may influence recurrence of atrial fibrillation.Conclusion The plasma of BNP levels before cadioversion are elevated in patients with AF,the plasma concentration of BNP fall after successful cardioversion.The diameter of left atrium may influence recurrence of atrial fibrillation and levels of the plasma of BNP,BNP has important value on prediction,treatment and prognosis of AF.