N-末端脑钠肽前体对冠状动脉旁路移植术术后房颤的预测价值

目的:探讨N-末端脑钠肽前体对冠状动脉旁路移植术术后房颤的预测价值.方法:收集来我院住院行冠状动脉旁路移植术患者132例的临床资料,均为2011年9月至2015年1月的病例,观察的结局事件是术后房颤事件,分为房颤组39例和窦律组93例,收集所有患者的基本资料,包括年龄、性别、BMI、EuroScore、NYHA分级、基础疾病(高血压、糖尿病)、口服药物(β受体拮抗剂、钙离子通道阻滞剂、他汀类药物)、重症监护时间、呼吸机使用时间等,记录心脏彩超(LAD、LVESD、IVST、LVEDD、LVEF)和生化检查(NT-proBNP、hs-CRP、ALT、AST、Cr、RDW、RBC),以术后房颤为因变量,以单因素分析有差异的指标为自变量,行Logistic多因素回归分析.结果:术后房颤发生率为29.55％(39/132),CCABG组房颤发生率(46.94％)高于OPCAB组(19.28％),差异有统计学意义(P<0.05);房颤组和窦律组在平均年龄、EuroScore、NYHA分级、重症监护时间、呼吸机使用时间、β受体拮抗剂上,差异有统计学意义(P<0.05);房颤组和窦律组在术后24h LAD、术后24h LVEF上,差异有统计学意义(P<0.05);房颤组和窦律组在NT-proBNP、术后24h hs-CRP、术后24h RDW上,有差异(P<0.05);年龄、术后24h LAD、NT-proBNP为冠状动脉旁路移植术术后房颤发生的独立预测因素(P<0.05).结论:年龄、术后24h LAD、NT-proBNP为冠状动脉旁路移植术术后房颤发生的独立预测因素.

Predictive Value of N-terminal Brain Natriuretic Peptide Precursor for Atrial Fibrillation after Coronary Artery Bypass Grafting

Objective:To investigate the diagnostic value of N-terminal brain natriuretic peptide(BNP)in patients with atrial fibrillation after coronary artery bypass grafting(CABG).Methods: 132 cases in our hospital underwent coronary artery bypass grafting were selected in September 2011 to January 2015 were the observation of outcomes were atrial fibrillation events after operation,39 cases divided into AF group and 93 cases into sinus rhythm group,the basic data of all patients were collected,including age BMI,EuroScore,NYHA,gender,grade,basic diseases(hypertension,diabetes),oral drugs(beta blockers,calcium channel blockers,statins),intensive care time,ventilator time,record cardiac ultrasound(LAD,LVESD,IVST,LVEDD,LVEF(NT-proBNP)and biochemical examination ALT,AST,hs-CRP,Cr,RBC,RDW),the dependent variable of postoperative atrial fibrillation,using single factor analysis of the difference between indicators as independent variables,multivariate regression analysis for Logistic.Results: The incidence of postoperative atrial fibrillation was 29.55％(39/132),the incidence of atrial fibrillation in CCABG group(46.94％)was higher than that of OPCAB group(19.28％),there are differences(P<0.05).AF group and sinus rhythm group in average age,EuroScore,NYHA grade,intensive care time,ventilator time,beta receptor antagonist,difference(P<0.05).AF group and sinus rhythm group in postoperative 24h LAD,after 24h LVEF,there are differences(P<0.05).AF group and sinus rhythm group at NT-proBNP,24h after surgery and postoperative 24h hs-CRP RDW,there are differences(P<0.05).age,postoperative 24h LAD,NT-proBNP after surgery as an independent predictor of coronary artery bypass grafting with atrial fibrillation(P<0.05).Conclusion: Age,postoperative 24h,LAD,and NT-proBNP were independent predictors of atrial fibrillation after coronary artery bypass grafting.