摘要
目的 研究N末端B型利钠肽原（N-terminal pro-brain natriuretic peptide,NT-proBNP）与急性心肌梗死（acute myocardial infarction,AMI）患者合并初发心房颤动（new onset atrial fibrillation,NOAF）事件的相关性.方法 入选2006-01～2011-06哈尔滨医科大学附属第一医院心内科行急诊经皮冠脉介入治疗并完全开通罪犯血管的1592例AMI患者,根据典型胸痛后7 d内是否合并NOAF事件,将AMI患者分为心房颤动（房颤）患者（100例）和无房颤患者（1492例）.将房颤患者作为房颤组（100例）,选取与房颤组一般临床情况相仿的无房颤患者作为对照组（200例）.记录两组患者的一般临床情况,测定NT-proBNP,并进行统计学分析.结果 房颤组NT-proBNP水平明显高于对照组 （1565.45 pg/mL vs 1212.17 pg/mL,P〈0.01）.多元Logistic回归分析显示,NT-proBNP水平对NOAF的预测能力最强（OR=5.783,P〈0.01）,其次为房性早搏频发、C反应蛋白和P波离散度增大（OR分别为2.717、2.393、2.140,P〈0.01）及基础心率增快、P波时限增大（OR分别为1.992、1.558,P〈0.05）.结论 NT-proBNP优于传统危险因素,可以用于NOAF发作的预测和危险分层.
Objective To investigate the relationship between serum N -terminal pro- brain natriuretic peptide（ NT- proBNP） levels and new onset atrial fibrillation（NOAF） in patients with acute myocardial infarction（AMI）. Methods 1592 AMI patients with percutaneous coronary intervention （PCI） （100 with NOAF, 1492 without NOAF） had opened culprit vessel, and were divided into two groups based on with or without NOAF within 7 days after AMI： 100 with NOAF as AF group, 200 selected from those without NOAF as control group. General clinical characters were documented and serum NT - proBNP levels were obtained by ELISA. All the risk factors were evaluated to identify potential determinants for NOAF by univariate and multivariate analysis. Results Serum NT - proBNP levels were higher in AF group than in control group（ 1565.45 pg/mL vs 1212.17 pg/mL, P 〈 0.01 ）. The final regression model showed that elevated serum NT- proBNP level was the most important independent predictor for NOAF （ OR = 5. 783, P 〈 0. 01 ）, followed by frequent premature atrial beats, elevated serum CRP level and increased Pd （OR were 2. 717, 2. 393 and 2. 140,P 〈 0. 01 ） , higher heart rate, increased Pmax （ OR were 1. 992 and 1. 558, P 〈 0.05 ）. Conclusion Elevated level of serum NT- proBNP was superior to other traditional risk factors for the prediction and risk stratification for NOAF.
出处
《中国急救医学》
CAS
CSCD
北大核心
2012年第5期390-393,共4页
Chinese Journal of Critical Care Medicine
