NT-pro-BNP水平与心房颤动类型关系的探讨

摘要

Objective To explore the relationship of the types of atrial fibrillation and levels of NT-pro-BNP in atrial fibrillation patients. Methods 141 patients with atrial fibrillation admitted in the emergency department were consecutively enrolled in the study,including 85 paroxysmal atrial fibrillation,35 persistent atrial fibrillation and 21 permanent atrial fibrillation. Another 30 non-arrhythmic patients were enrolled in as control. Any patients with heart failure,kidney dysfunction, or COPD were excluded. Levels of NT-pro-BNP were measured by immunoluminescence assay. Results The levels of NT-pro-BNP in control were lower than those in atrial fibrillation(215.5±102.2pg/mL vs 825.2±186.4pg/mL,P<0.01). And levels of NT-pro-BNP in permanent atrial fibrillation were higher than those in persistent atrial fibrillation(2103.3±680.2pg/mL vs 696.4±183.0pg/mL,P<0.001) and paroxysmal atrial fibrillation(2103.3±680.2pg/mL vs 562.7±113.9pg/mL,P<0.001), but the levels of NT-pro-BNP between paroxysmal atrial fibrillation and persistent atrial fibrillation were not significant (696.4±183.0pg/mL vs 562.7±113.9pg/mL,P>0.05). Conclusion NT-pro-BNP level increases during atrial fibrillation, and the levels of NT-pro-BNP in permanent atrial fibrillation are significantly higher than those in persistent and paroxysmal atrial fibrillation.%　　目的探讨各类型心房颤动与N末端脑利钠肽前体（NT-pro-BNP）水平的关系。方法连续入选急诊入院心房颤动患者共141例，排除心力衰竭、肾功能衰竭、慢性阻塞性肺疾病患者，其中阵发性心房颤动85例，持续性心房颤动患者35例，永久性心房颤动患者21例。另选30例无心力衰竭、无肾功能衰竭、无心律失常患者作对照。患者于入院后4～24 h内完成超声心动图、心电图检查，留取静脉血10ml，采用化学发光法检测NT-pro-BNP，并检测电解质。结果对照组NT-pro-BNP（215.5±102.2）pg/ml，低于房颤组的（825.2±186.4）pg/ml，差异有统计学意义（P<0.01）。永久性心房颤动组患者血浆NT-pro-BNP （2103.3±680.2）pg/ml，显著高于持续性心房颤动组的（696.4±183.0）pg/ml及阵发性心房颤动组的（562.7±113.9）pg/ml，差异均有统计学意义（P<0.01），持续性心房颤动与阵发性心房颤动组血浆NT-pro-BNP水平差异无统计学意义。结论急诊室房颤患者NT-pro-BNP水平显著升高并与房颤类型有密切相关，永久性心房颤动患者NT-pro-BN水平明显高于持续性心房颤动及阵发性心房颤动。