阵发性心房颤动患者血清N-末端脑钠肽前体水平变化及其临床意义

目的:观察心房颤动(房颤)对非瓣膜性心脏病患者血清N-末端脑钠肽前体(NT-proBNP)水平的影响,并探讨其临床意义.方法:采用ELISA法测定98例非瓣膜性心脏病阵发性房颤及40例窦性心律患者血清NT-proBNP水平.对阵发性房颤患者采取药物复律,测定复律前后血清NT-proBNP水平变化.结果:阵发性房颤患者血清NT-proBNP水平明显高于窦性心律患者(P＜0.01);成功复律的阵发性房颤患者复律前NT-proBNP水平明显高于成功复律后(P＜0.01);未成功复律者复律前后NT-proBNP水平比较差异无统计学意义(P＞0.05);成功复律者复律前的NT-proBNP水平明显低于未成功复律者(P＜0.01).结论:房颤是影响脑钠肽分泌的重要因素,入院时血清NT-proBNP水平对房颤药物复律效果具有预测价值.

The change of serum NT-proBNP in patients with paroxysmal atrial fibrillation and its clinical significance

Objective:To observe the effect of paroxysmal atrial fibrillation on the serum NT-proBNP level in patients with nonvalvular heart diseases and investigate its clinical significance.Method:The serum concentration of NT-proBNP in 98 patients with nonvalvular paroxysmal atrial fibrillation(PAf) and 40 patients with sinus rhythm were measured by ELISA method after admission.All patients with PAf were treated by oral loading-dose of propafenone(450-600 mg) within 1h after admission.The serum NT-proBNP concentration was measured after conversion therapy.Result:The serum NT-proBNP level in patients with nonvalvular PAf was higher than that in patients with sinus rhythm(P<0.01).It was decreased significantly after successful drug conversion(P<0.01).There was no significant difference of serum NT-proBNP concentration in PAf patients non-conversed to sinus rhythm before and after propafenon treatment(P>0.05).The serum NT-proBNP level in patients with successful drug conversion was lower than that in patients with non-successful conversion.Conclusion:Af is a significant factor influencing the secretion of BNP in patients with nonvalvular heart diseases and serum NT-proBNP level can be used as a biochemical marker to predict the successful drug conversion of PAf.