慢性持续性心房颤动患者心率控制对血清hsCRP和NT-proBNP的影响

目的：探讨美托洛尔控制慢性持续性心房颤动患者心率对炎症反应和心功能的影响.方法：130例慢性持续性心房颤动患者按静息心率水平分为：高心率房颤组（心率≥90次/min,70例）和低心率房颤组（心率＜90次/min,60例）,另入选窦性心律对照组20例.高心率房颤组在基础治疗上给予美托洛尔（50mg/d）,治疗前及治疗后1月测定血清高敏C反应蛋白（hsCRP）及N端脑钠素前体（NT-proBNP）浓度.结果：治疗前高心率房颤组hsCRP水平显著高于低心率房颤组（9.23±4.39） mg/L比（5.97±2.85） mg/L,P＜0.01].所有患者均完成随访.与治疗前比较,治疗1月后高心率房颤组患者心率显著下降（110±19）次/min比（83±25）次/min,P＜0.01],且与低心率房颤组比较无显著差异（P＞0.05）,临床症状明显改善（P＜0.01）.高心率房颤组治疗后心率≥90次/min患者的hsCRP水平明显高于心率＜90次/min的患者（P＜0.01）.结论：慢性持续性心房颤动患者的高敏C反应蛋白水平与静息心率有关,控制心率可减轻炎症反应,而对反映心功能的N端脑钠素前体无明显影响.

Influence of controlling heart rate on serum levels of hsCRP and NT-proBNP in patients with chronic permanent atrial fibrillation

Objective：To explore influence of heart rate （HR） control on inflammatory reaction and heart function in patients with chronic permanent atrial fibrillation.Methods：According to resting heart rate,a total of 130 patients with chronic permanent atrial fibrillation were divided into high HR atrial fibrillation group （HR≥90 times/min,n=70） and low HR atrial fibrillation group （HR〈90 times/min,n =60）.Another 20 cases with sinus rhythm were enrolled as sinus rhythm control group.High HR group received 50 mg/d metoprolol based on routine treatment.The serum hsCRP,and NT-proBNP concentration were measured before and one month after treatment.Results：：Before treatment,compared with low HR atrial fibrillation group there was significant increase in hsCRP level （5.97± 2.85） mg/L vs.（9.23± 4.39） mg/L,P〈0.01] in high HR atrial fibrillation group.All patients finished the follow up.Compared with before treatment,there were significant improvement in clinical symptoms and significant decrease in HR （110± 19） times/min vs.（83 ± 25） times/min,P〈0.01 all] and was not significant difference than those of low HR atrial fibrillation group after treatment （P〉0.05）.After treatment,hsCRP level of patients with HR≥90 times/min was significantly higher than that of patients with HR〈90 times/min in high HR atrial fibrillation group （P〈0.01）.Conclusion：Level of hsCRP is related to resting heart rate in patients with chronic permanent atrial fibrillation.Controlling heart rate can relieve inflammatory reaction.