NT-proBNP、D-二聚体水平与心脏手术后新发房颤的关系分析

摘要

Objective To analyze the relationship between the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as well as D-dimer(D-D) and new-onset atrial fibrillation(POAF) after cardiac surgery.Methods A total of 150 patients who underwent mitral valve replacement in our hospital from January 2012 to January 2017 were enrolled in the study,and these patients were divided into atrial fibrillation group (n =60) and non atrial fibrillation group (n =90) according to whether who had POAF after operation. The clinical data were retrospectively analyzed,and the relationship between the levels of NT-proBNP as well as D-D and POAF after operation was analyzed.Results There were no significant differences in the clinical baseline data,laboratory indexes including GLU,TC,TG,LDL and HDL between two groups (P>0.05).However the levels of NT-proBNP,D-D,IL-6 and hs-CRP in atrial fibrillation group were significantly higher than those in non atrial fibrillation group (P<0.05).The multivariate analysis showed that NT-proBNP,D-D,IL-6 and hs-CRP were the risk factors of POAF after cardiac surgery (P <0.05). Conclusion The main risk factors of POAF after cardiac surgery include NT-proBNP,D-D,IL-6 and hs-CRP,and the increase of these indexes levels can provide reference for predicting POAF after operation.%目的 分析N端前脑钠肽(NT-proBNP)、D-二聚体(D-D)水平与心脏手术后新发房颤(POAF)的关系.方法 将2012年1月至2017年1月收治的150例行二尖瓣置换术病例纳入研究,依据术后是否有POAF分为房颤组( n =60)与非房颤组( n =90),对其临床资料进行回顾性分析,并归纳NT-proBNP、D-D水平与术后POAF之间的关系.结果 2组临床基线资料、实验室指标空腹血糖(GLU)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)比较差异无统计学意义(P>0.05);房颤组NT-proBNP、D-D、白介素-6(IL-6)、起敏C-反应蛋白(hs-CRP)水平均显著高于非房颤组(P<0.05);多因素分析显示,血NT-proBNP、D-D、IL-6、hs-CRP均属于心脏手术后POAF危险因素(P<0.05).结论 心脏手术后POAF主要危险因素包括NT-proBNP、D-D、IL-6、hs-CRP,其水平的提升可为术后POAF预测提供参考.