摘要
目的分析血浆脑钠肽(BNP)对冠状动脉粥样硬化性心脏病(冠心病,CHD)合并心房纤颤(AF)患者发生心房血栓事件的预测价值。方法入选98例的CHD合并AF患者,依据有无左心房血栓分为:对照组(52例,未发生心房血栓)、研究组(46例,发生心房血栓)。检测并比较两组患者的血浆BNP、糖化血红蛋白(HbA1c)、总胆固醇(TC)、氧化低密度脂蛋白(ox-LDL)、高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(hs-CRP)水平以及心脏超声指标左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)及左房直径(LAD)的差异。应用多元Logistic回归分析上述指标与患者心房血栓发生的相关性。结果与对照组相比,研究组患者BNP、hs-CRP、ox-LDL、LVEDd、LAD水平显著升高,分别为:[(358.6±77.8)pg/ml vs.(1102.9±315.7)pg/ml,P=0.001];[(5.8±1.0)mg/L vs.(7.4±1.3)mg/L,P=0.027]、[(3.4±0.8)mmol/L vs.(4.0±0.9)mmol/L,P=0.038]、[(58.1±5.5)mm vs.(74.3±6.8)mm,P=0.030]、[(32.5±3.8)mm vs.(39.6±4.3)mm,P=0.021],LVEF、HDL-C则明显降低,分别为:[(57.3±3.8)%vs.(48.2±3.1)%,P=0.015]、[(1.08±0.27)mmol/L vs.(0.72±0.16)mmol/L,P=0.029],差异均有统计学意义;而HbA1C、TC水平无统计学差异(P>0.05)。多元Logistic回归分析显示,BNP(OR=1.986,P=0.009)与LAD(OR=0.863,P=0.028)为心房血栓发生的独立预测因子。结论 BNP能独立预测CHD合并AF患者心房血栓的发生。
Objective To analyze the predictive value of plasma B-type natriuretic peptide （BNP） to atrial thrombosis in patients with coronary heart disease （CHD） complicating atrial fibrillation （AF）. Methods The patients （n=98） were divided, according to the occurrence of left atrial thrombus, into control group （n=52, without atrial thrombosis） and research group （n=46, with atrial thrombosis）. The levels of BNP, glycated hemoglobin （HbAlc）, total cholesterol （TC）, oxidized low-density lipoprotein （ox-LDL）, high-density lipoprotein-cholesterol （HDL-C）, high-sensitivity C-reactive protein （hs-CRP）, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVEDd） and left atrial diameter （LAD） were detected and compared in 2 groups. The correlation between above indexes and left atrial thrombosis was analyzed by using multiple Logistic regression analysis. Results Compared with control group, in research group the levels of BNP [（358.6±77.8） pg/ml vs. （1102.9 ±315.7） pg/ml, P=0.001], hs-CRP [（5.8±1.0） mg/L vs. （7.4±1.3） mg/L, P=0.027], ox-LDL [（3.4±0.8） mmol/L vs. （4.0±0.9） mmol/L, P=0.038], LVEDd [（58.1±5.5） mm vs. （74.3±6.8） mm, P=0.030] and LAD [（32.5±3.8） mm vs. （39.6±4.3） mm, P=0.021] increased significantly, and LVEF [（57.3±3.8）%vs. （48.2±3.1）%, P=0.015] and HDL-C [（1.08±0.27） mmol/L vs. （0.72±0.16） mmol/L, P=0.029] decreased significantly. The levels of HbA1C and TC had no statistical difference between 2 groups （P〉0.05）. The multiple Logistic regression analysis showed that BNP （OR=1.986, P=0.009） and LAD （OR=0.863, P=0.028） were independent predictive factors of atrial thrombosis. Conclusion BNP can independently predict atrial thrombosis in patients with CHD complicating AF.
出处
《中国循证心血管医学杂志》
2014年第4期480-482,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
B型利钠肽
冠心病
心房颤动
血栓
B-type natriuretic peptide
Coronary heart disease
Atrial fibrillation
Thrombosis
