高血压伴阵发性房颤患者 NT-proBNP与心功能指标的相关性研究

摘要

Objective To investigate the correlation of plasma N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) level with echocardiographic indicators and P wave terminal force of lead V 1 (PtfV1) in the patients with hypertension and paroxysmal atrial fibrillation(PAF) .Methods Fifty‐six outpatients and inpatients with hypertension were divided into the PAF group (n=26) and the sinusrhythm group (n=30) .Thirty age‐matched and gender‐matched healthy volunteers were taken as the control group . The plasma NT‐proBNP level was determined .Left ventricular enddiastolic diameter (LVEDD) ,left atrial diameter(LAD) and left ventricular ejection fraction(LVEF) were examined by echocardiography .the 12‐lead electrocardiogram was routinely performed Pt‐fV1 was calculated .Results The plasma NT‐proBNP level in the PAF group was higher than that in the sinusrhythm group and the control group ,the difference was statistically significant (P<0 .05) .The plasma NT‐proBNP level in the PAF group was de‐creased significantly after successful cardioversion .The plasma NT‐proBNP level in the PAF group was positively correlated with LVEDD(r=0 .543 ,P<0 .05) and LAD (r=0 .606 ,P<0 .01) .The plasma NT‐proBNP level was negatively correlated with LVEF (r= -0 .750 ,P<0 .01) and positively correlated with the PtfV 1 absolute value (r= 0 .513 ,P< 0 .01) .Conclusion The plasma NT‐proBNP level can better reflect the heart structure and function in the patients with atrial fibrillation .Detecting the plasma NT‐proBNP level combined with echocardiographic indicators and PtfV 1 is conducive to comprehensively assess the heart function in the patients with hypertension and PAF .%目的：探讨高血压伴阵发性房颤（PAF）患者血浆N末端B型利钠肽原（NT‐proBNP）水平与超声心动图指标、心电图V1导联P波终末电势（PtfV1）的相关性。方法将56例高血压患者分为阵发性房颤组（n＝26）及窦性心律组（n＝30），并选取年龄和性别与入选患者匹配的健康志愿者30例作为对照组。测定血浆NT‐proBNP水平，利用超声心动图测定左室舒张末期内径（LVEDD）、左房内径（LAD）及左室射血分数（LVEF），常规描记12导联心电图并计算PtfV1。结果阵发性房颤组的NT‐proBNP水平高于窦性心律组及对照组，差异有统计学意义（P＜0．05），阵发性房颤组复律后NT‐proBNP水平显著减低。阵发性房颤组血浆NT‐proBNP水平与LVEDD呈正相关（r＝0．543，P＜0．05），与LAD呈正相关（r＝0．606，P＜0．01），与LVEF呈负相关性（r＝－0．750，P＜0．01），与PtfV1绝对值呈正相关（r＝0．513，P＜0．01）。结论测定高血压伴阵发性房颤患者血浆NT‐proBNP水平，结合超声心动图指标及PtfV1，有助于综合评估患者心功能。