N末端脑钠肽前体及高敏C反应蛋白在阵发陛心房纤颤患者中的应用

目的研究测量血清N末端脑纳肽前体（N-terminalpro-brainnatriureticpeptide，NT-pro-BNP）及高敏C反应蛋白（high-sensitivityc-reactiveprotein，hs-CRP）浓度在阵发性心房纤颤的应用价值。方法选择中山市人民医院2007年1月至2010年1月明确诊断为阵发性心房纤颤的患者60例为研究对象（心房纤颤组）。予以胺碘酮注射液（5ITIg／kg，静脉注射；600mg／24h，静脉注射）治疗后，分为复律组（38例）、未复律组（22例）。另外，选取同期住院非瓣膜性心脏病窦性心律患者60例为窦律组。分别测量各组血清NT-pro-BNP及hs-CRP浓度，并进行比较。结果治疗前心房纤颤组血清NT-pro-BNP及hs-CRP浓度显著高于窦律组，差异有统计学意义NT．pro-BNP：（619．3±275．0）ng／LVS．（235．2±80．4）ng／L，P〈0．05；hs-CRP：（4．5±O．7）ng／L、（6．9±1．2）ng／L7）8．（1．1±0．6）ng／L，P〈0．05]。复律组血清Nt-pro-BNP及hs．CRP浓度明显低于复律前，差异有统计学意义（460．6±162．7）ng／Lus（699．6±310．0）ng／L，P〈0．05；（1．3±0．6）ng／Lus．（4．5±0．7）ng／L，P〈0．05]。复律组复律后血清NT-pro-BNP及hs-CRP浓度与窦律组比较，差异无统计学意义（P〉0．05）。复律前复律组血清NT-pro-BNP及hs-CRP浓度与未复律组比较，差异无统计学意义（P〉0．05）。结论NT．pro-BNP及hs-CRP可能参与心房纤颤的发生、发展，测量NT．pro-BNP及hs-CRP浓度在心房纤颤的治疗及预后判断方面有一定的应用价值。

Application of N-terminal pro-brain natriuretic peptide and high-sensitivity C-reactive protein in patients with paroxysmal atrial fibrillation

Objectives To analyze the application of measuring serum concentrations of N-terminal pro-brain natriuretic peptide(NT-pro-BNP) and high-sensitivity C-reactive protein(hs-CRP) in patients with paroxysmal atrial fibrillation.Methods Sixty patients diagnosed with paroxysmal atrial fibrillation in the People’s Hospital of Zhongshan City from Jan.2007 to Jan.2010(atrial fibrillation group) were treated by loading dose of amiodarone(5 mg/kg,intravenous injection;600 mg/24 h,intravenous injection).After cardioversion therapy,patients were divided into cardioversion group(n=38) and noncardioversion group(n=22).Meanwhile,60 patients with non-valvular heart disease in sinus rhythm were selected as sinus rhythm group.Serum concentrations of NT-pro-BNP and hs-CRP in all groups were measured and compared.Results Before treatment,serum concentrations of NT-pro-BNP and hs-CRP in atrial fibrillation group were siginificantly higher than those in sinus rhythm group NT-pro-BNP:(619.3±275.0) ng/L vs.(235.2±80.4) ng/L,P<0.05;hs-CRP:(4.5±0.7) ng/L &(6.9±1.2) ng/L vs.(1.1±0.6) ng/L,P<0.05].Serum concentrations of NTt-pro-BNP and hs-CRP in cardioversion group were significantly lower after cardioversion treatment (460.6±162.7) ng/L vs.(699.6±310.0) ng/L,P<0.05;(1.3±0.6) ng/L vs.(4.5±0.7) ng/L,P<0.05].Serum concentrations of NT-pro-BNP and hs-CRP between cardioversion group after cardioversion treatment and sinus rhythm group had no significant differences(P>0.05).There were no significant differences in serum concentrations of NT-pro-BNP and hs-CRP between cardioversion group and noncardioversion group before cardioversion treatment(P>0.05). Conclusions NT-pro-BNP and hs-CRP may be involved in the formation and development of atrial fibrillation.Measuring serum concentrations of NT-pro-BNP and hs-CRP has value in the treatment and prognosis estimate of atrial fibrillation.