N-末端脑利肭肽前体水平与心衰合并房颤患者复律及脑梗死的关系被引量：4

Relationship among cardioversion,cerebral infarction and NT-proBNP level in patients with heart failure complicated atrial fibrillation

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摘要目的:探讨N-末端脑利肭肽前体(NT-proBNP)水平与心衰合并房颤患者复律及脑梗死的关系。方法:150例心衰合并房颤患者接受静脉滴注胺碘酮复律治疗,根据复律结果分为复律组(100例)和未复律组(50例),观察两组复律前后NT-proBNP水平的变化。根据是否发生脑梗死,患者被分为脑梗死组(20例)和无脑梗死组(130例),比较两组发病前后的NT-proBNP水平。结果:服药后48h内100例(66.67%)患者转复为窦性心律。与复律前比较,复律组复律后NT-proBNP水平显著降低[(967.04±366.16)pg/ml比(496.21±142.54)pg/ml],且显著低于未复律组(996.76±351.28)pg/ml,P均<0.01]。脑梗死组中,与小面积脑梗死组比较,中,大面积梗死组NT-proBNP水平[(784.21±231.26)pg/ml比(1983.24±32.96)pg/ml,(3562.19±1468.32)pg/ml]显著升高,P均<0.05或<0.01。结论:入院时NT-proBNP水平对心衰合并房颤患者药物复律效果具有预测价值。NT-proBNP水平与脑梗死的发生有关。急性脑梗死后NT-proBNP水平越高,梗死面积越大,预后越差。 Objective.. To explore the relationship among cardioversion, cerebral infarction （CI） and N terminal pro brain natriuretic peptide （NT-proBNP） level in patients with heart failure （HF） complicated atrial fibrillation （AF）. Methods： A total of 150 HF ＋ AF patients received intravenous drip of amiodarone for cardioversion therapy. Ac- cording to cardioversion results, they were divided into cardioversion group （n = 100） and non-cardioversion group （n = 50）, NT-proBNP level change was observed in two groups before and after cardioversion. According to CI on- set or not, patients were divided into CI group （n = 20） and non-CI group （n = 130）, NT-proBNP level was com- pared between two groups before and after onset. Results： Within 48h after administration, a total of 100 patients （66. 67%） recovered to sinus rhythm. Compared with before cardioversion, NT-proBNP level significantly reduced [ （967. 04 ± 366. 16） pg/ml vs. （496. 21±142.54） pg/ml] after cardioversion in cardioversion group, and was signifi- cantly lower than that of non-cardioversion group （996. 76 ± 351.28） pg/ml, P〈0.01 all. In CI group, compared with small size CI group, there were significant rise in NT-proBNP level [ （784. 21 ± 231.26） pg/ml vs. （1983.24 ± 32.96） pg/ml, （3562.19± 1468. 32） pg/ml] in medium and large size CI group, P〈0.05 or 〈0.01. Conclusion： NT-proBNP level at hospitalization possesses predictive value for drug cardioversion effect in HF ＋ AF patients. NT-proBNP level is related with CI onset. After acute CI, the higher NT-proBNP level is, the larger infarct size is, the poorer prognosis is.

作者赵玉红孙红凤王雷钧钱春贤陈爱军石磊陈凯峰孙静

机构地区上海市松江区泗泾医院内科

出处《心血管康复医学杂志》 CAS 2015年第5期498-501,共4页 Chinese Journal of Cardiovascular Rehabilitation Medicine

基金 2012年上海市松江区卫生科研课题(2012-Ⅲ-14)~~

关键词房颤利钠肽脑脑梗死胺碘酮 Atrial fibrillation Natriuretic peptide, brain Brain infarction Amiodarone

分类号 R541.750.9 [医药卫生—心血管疾病]

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参考文献15

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