Objective To analyze the relationship between serum BNP level and arrhythmia in postoperative coronary heart disease patients treated by PCI.Methods A total of 118 coronary heart disease patients undergoing PCI were selected in Xi′an Hospital of China Aviation Industry from April 2013 to August 2016,and they were divided into A group(complicated with arrhythmia,n=52)and B group(did not complicated with arrhythmia,n=66)according to the incidence of arrhythmia after PCI.General information,laboratory examination results,index of cardiac function,serum BNP level before and after PCI were compared between the two groups;influencing factors of arrhythmia in postoperative coronary heart disease patients treated by PCI were analyzed by multivariate Logistic regression analysis,and ROC curve was drawn to evaluate the predictive value of serum BNP level before PCI on arrhythmia in postoperative coronary heart disease patients treated by PCI.Results The incidence of arrhythmia was 44.07%(52/118).No statistically significant differences of BMI,smoking rate,incidence of hypertension or diabetes,heart rate,TG,TC,WBC or LVEDD was found between the two groups(P>0.05);while there were statistically significant differences of age,serum kalium,FPG,CRP,LVEF,serum BNP level before and after PCI between the two groups(P<0.05).Multivariate Logistic regression analysis results showed that,serum BNP level before PCI was one of influencing factors of arrhythmia in postoperative coronary heart disease patients treated by PCI〔OR=2.829,95%CI(1.949,3.709)〕.ROC curve showed that,AUC of serum BNP level before PCI in predicting arrhythmia in postoperative coronary heart disease patients treated by PCI was 0.813〔95%CI(0.643,0.967)〕,the optimum truncation value was 310 ng/L,the sensitivity was 92.60%,the specificity was 54.30%.Conclusion Incidence of arrhythmia is significantly high in postoperative coronary heart disease patients treated by PCI,serum BNP level before PCI is one of influencing factors of arrhythmia in postoperative coronary heart disease patients treated by PCI,has certain predictive value on arrhythmia..%目的 分析血清脑钠肽(BNP)水平与冠心病患者经皮冠状动脉介入治疗(PCI)后心律失常的相关性.方法 选取2013年4月-2016年8月在中航工业西安医院行PCI的冠心病患者118例,根据PCI后心律失常发生情况分为心律失常组52例与非心律失常组66例.比较两组患者临床资料、实验室检查指标、心功能指标及PCI前后血清BNP水平;冠心病患者PCI后心律失常的影响因素分析采用多因素Logistic回归分析,绘制ROC曲线以评价PCI前血清BNP水平对冠心病患者PCI后心律失常的预测价值.结果 本组患者心律失常发生率为44.07%(52/118).两组患者体质指数(BMI)、吸烟率、高血压发生率、糖尿病发生率、心率、三酰甘油(TG)、总胆固醇(TC)、白细胞计数(WBC)、左心室舒张末期内径(LVEDD)比较,差异无统计学意义(P>0.05);两组患者年龄、血钾、空腹血糖、C反应蛋白(CRP)、左心室射血分数(LVEF)及PCI前后血清BNP水平比较,差异有统计学意义(P<0.05).多因素Logistic回归分析结果显示,PCI前血清BNP水平是冠心病患者PCI后心律失常的影响因素〔OR=2.829,95%CI(1.949,3.709)〕.绘制ROC曲线发现,PCI前血清BNP水平预测冠心病患者PCI后心律失常的曲线下面积(AUC)为0.813〔95%CI(0.643,0.967)〕,最佳截断值为310 ng/L,灵敏度为92.60%,特异度为54.30%.结论 冠心病患者PCI后心律失常发生率较高,PCI前血清BNP水平是冠心病患者PCI后心律失常的影响因素,其对冠心病患者PCI后心律失常具有一定的预测价值.
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