目的:比较不同类型房颤患者血浆中B型钠尿肽(BNP)水平及心脏结构变化。方法:顺序入选阵发性房颤患者35例,持续性房颤患者30例,另设无房颤患者30例作为对照组。详细记录各组患者基线资料、血浆BNP水平以及超声心动图测量数据。结果:持续性房颤组患者血浆BNP平均水平明显高于阵发性房颤组(P<0.001),且这两组患者血浆BNP平均水平均明显高于对照组患者(P <0.001)。3组患者间左心房内径(LAD)(P<0.001)及右心室舒张末期内径(RVDd)(P= 0.023)存在显著差异。血浆BNP水平与超声指标LAD呈正相关(r = 0.419,P<0.001)。结论:血浆BNP水平随房颤进展而升高,并与房颤患者LAD呈显著正相关。
?
(63.93 ± 69.78, P <0.001). The blood BNP levels were positively correlated with LAD (r=0.419, P <0.001). Conclusion: The plasma BNP levels tend to increase with the development of atrial fibrillation, and are significantly positively correlated with LAD in patients with atrial fibrillation.
[1]赵丽,吴学思.B型利钠肽在心血管疾病中的作用研究进展[J].中国急救医学,2003,(5):41
[2] Yilmaz M B, Erbay A R, Balci M, et al. Atrial natriuretic peptide predicts impaired atrial remodeling and occurrence of late postoperative atrial fibrillation after surgery for symptomatic aortic stenosis[J]. Cardiology , 2006, 105(4) : 207
[3] Sanghamitra M, Prasant M, Luigi D B, et al. Baseline B-Type natriuretic peptide: a gender-specific predictor of procedure-outcome in atrial fibrillation patients undergoing catheter ablation[J]. J Cardiovasc Electrophysiol, 2011,22(8): 858
[4] Stephan D, Sarah V, Henrike F, et al. Predictive value of B-type natriuretic peptide levels in patients with paroxysmal and persistent atrial fibrillation undergoing pulmonary vein isolation[J]. J Interv Card Electrophysiol, 2011, 30(3):217
[5] Tang Y, Yang H, Qiu J. Relationship between brain natriuretic peptide and recurrence of atrial fibrillation after successful electrical cardioversion: a meta-analysis[J]. J Int Med Res, 2011, 39(5): 1618
[6] Phang R, Isserman S, Karia D, et al. Echocardiographic evidence of left atrial abnormality in young patients with lone paroxysmal atrial fibrillation[J]. Am J Cardiol, 2004, 94(4) : 511
[7] Rostagno C, Olivo G, Comegliom, et al. Left atrial size changes in patients with paroxysmal lone atrial fibrillation. An echocardiographic follow-up[J]. Angiology, 1996, 47(8) : 797
[8] Bosch R F, Grammer J B, Kuhlkamp V, et al. Electrical remodeling in atrial fibrillation—cellular and molecular mechanisms[J]. Z Kardiol, 2000, 89(9):795
[9] Leistad E, Aksnes G, Verburg E, et al. Atrial contractile dysfunction after short-term atrial fibrillation is reduced by verapamil but increased by BAY K8644[J]. Circulation, 1996, 93(9):1747
[10] White C W, Kerber R E, Weiss H R, et al. The effects of atrial fibrillation on atrial pressure-volume and flow relationships[J]. Circ Res,1982,51(2):205
[11]Verhorst P M, Kamp O, Welling R C, et al. Transesophageal echocardiographic predictors for maintenance of sinus rhythm after electrical cardioversion of atrial fibrillation[J]. Am J Cardiol, 1997, 79(10):1355
[12]Thamilarasan M, Klein AL. Factors relating to left atrial enlargement in atrial fibrillation: “Chicken or the egg” hypothesis[J]. Am Heart J, 1999, 137(3):381
[13] Kallel S, Jarrya A, Triki Z, et al. The use of N-terminal pro-brain natriuretic peptide as a predictor of atrial fibrillation after cardiac surgery[J]. J Cardiovasc Surg (Torino),2013,54(3):403
[14] Francia P, Ricotta A, Frattari A, et al. Atrial natriuretic Peptide single nucleotide polymorphisms in patients with nonfamilial structural atrial fibrillation[J]. Clin Med Insights Cardiol, 2013, 7: 153
[15]Silvet H, Young-Xu Y, Walleigh D, et al. Brain natriuretic peptide is elevated in outpatients with atrial fibrillation[J]. Am J Cardiol, 2003, 92(9):1124
[16] Vanderheyden M, Vrints C, Verstreken S, et al. B-type natriuretic peptide as a marker of heart failure: new insights from biochemistry and clinical implications[J]. Biomark Med, 2010, 4(2):315
[17]Tosa S, Watanabe H, Iino K, et al. Usefulness of plasma BNP levels as a marker of left ventricular wall stress in obese individuals[J]. Int Heart J, 2009, 50(2):173
[18] Mandalenakis Z, Eriksson H, Welin L, et al. Atrial natriuretic peptide as a predictor of atrial fibrillation in a male population study. The Study of Men Born in 1913 and 1923[J]. Int J Cardiol, 2014, 171(1):44
[19] Cheung B M, Kumana C R. Natriuretic peptides--relevance in cardiovascular disease[J]. JAMA, 1998, 280(23):1983
[20] Jourdain P, Bellorini M, Funck F, et al. Short-term effects of sinus rhythm restoration in patients with lone atrial fibrillation: a hormonal study[J]. Eur J Heart Fail, 2002, 4(3):263
[21] 郭俊晓,张玉龙,刘志平,等.先天性心脏病伴不同程度肺动脉高压患儿血浆脑钠肽及氨基末端脑钠肽前体的变化[J].中国医药,2015,10(11):1577
[22] 蒋春英,王蕊,李旭东,等.单纯收缩期高血压患者血浆B型钠尿肽水平与左心室肥厚、舒张功能变化的关系[J].中国动脉硬化杂志,2015,23(1):73
[23] 陈兴泳,张旭,雷惠新,等.急性脑梗死血N端-脑钠肽前体水平变化及临床意义[J]. 中国神经精神疾病杂志,2011,37(7):423
[24]饶志荣,杨友祥,王宁生,等.非瓣膜病性心房颤动患者血清CRPBNP与ET-1水平的测定及其临床意义[J].河北医学,2012,18(2):166
[25]徐颖,李广平,倪燕平,等.非瓣膜性心房颤动患者血清高敏C反应蛋白、脑钠肽、内皮素-1水平的测定及其临床意义[J].中国全科医学,2011,14(10):1095
[1]王爱芬,崔利军,马向红.非瓣膜性心房颤动左心房/左心耳血栓形成的相关因素分析[J].天津医科大学学报,2015,21(02):130.
WANG Ai-fen,CUI Li-jun,MA Xiang-hong.Related factors of left atrial or left atrial appendage thrombus formation in patients with non-valvular atrial fibrillation[J].Journal of Tianjin Medical University,2015,21(06):130.
[2]陈延勋,李广平. 非瓣膜性心房颤动患者尿酸与CHADS2、CHA2DS2-VASc评分的关系[J].天津医科大学学报,2015,21(03):185.
CHEN Yan-xun,LI Guang-ping. Relationship between uric acid and CHADS2/CHA2DS2-VASc Score in patients with nonvalvular atrial fibrillation[J].Journal of Tianjin Medical University,2015,21(06):185.
[3]崔占前,徐延敏.脂蛋白相关性磷脂酶A2及高敏C反应蛋白与左心房内径的关系[J].天津医科大学学报,2015,21(03):196.
CUI Zhan-qian,XU Yan-min.Relationship between plasma lipoprotein-associated phospholipase A2, high sensitivity C reactive protein and left atrial diameter[J].Journal of Tianjin Medical University,2015,21(06):196.
[4]付伟伟,李国东,王 喆.HDL-C与非瓣膜性心房颤动左心房/左心耳血栓形成的关系[J].天津医科大学学报,2015,21(06):498.
FU Wei-wei,LI Guo-dong,WANG Zhe.Relationship between high-density lipoprotein cholesterol and left atrial / left atrial appendage thrombus in non-valvular atrial fibrillation patients[J].Journal of Tianjin Medical University,2015,21(06):498.
[5]张彦月,林文华.vWF及血浆D-二聚体水平对非瓣膜性心房颤动患者血栓形成的诊断及临床预后价值[J].天津医科大学学报,2016,22(02):101.
ZHANG Yan-yue,LIN Wen-hua.Value of vWF and?D-dimer for thrombosis and prognosis in patients with non-valvular atrial fibrillation[J].Journal of Tianjin Medical University,2016,22(06):101.
[6]张邦滢 综述,李广平 审校.新型抗心律失常药物在心房颤动中的应用[J].天津医科大学学报,2017,23(01):90.
[7]张凤环,上官文锋,王学文,等.血管紧张素-(1-7)对快速心房起搏犬心房重构及p38MAPK蛋白表达的影响[J].天津医科大学学报,2019,25(05):450.
ZHANG Feng-huan,SHANGGUAN Wen-feng,WANG Xue-wen,et al.Effect of angiotensin-(1-7) on atrial remodeling and p38MAPK expression in a canine model of rapid atrial pacing[J].Journal of Tianjin Medical University,2019,25(06):450.
[8]杜春蕾,郭 牧,张云强,等.尼非卡兰和胺碘酮治疗急性心肌梗死新发房颤有效性和安全性对比研究[J].天津医科大学学报,2019,25(05):471.
DU Chun-lei,GUO Mu,ZHANG Yun-qiang,et al.Comparison of nifekalant and amiodarone in the treatment of new-onset atrial fibrillation in acute myocardial infarction patients[J].Journal of Tianjin Medical University,2019,25(06):471.
[9]张茂芃,陈炳伟,卢成志,等.脉冲场消融治疗心房颤动的短期及长期安全性临床研究[J].天津医科大学学报,2023,29(06):636.
ZHANG Mao-peng,CHEN Bing-wei,LU Cheng-zhi,et al.The short-term and long-term safety clinical trial of pulse field ablation to treat atrial fibrillation[J].Journal of Tianjin Medical University,2023,29(06):636.
作者简介 刘运龄(1991-),女,硕士在读,研究方向:心血管内科;通信作者:刘恩照,E-mail:liu_ezh@126.com。