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目的:探讨阵发性心房颤动(房颤)患者肺静脉电隔离术前后血浆心钠素(ANP)、N端脑钠素前体(NT-ProBNP)和超敏C反应蛋白(hs-CRP)变化的临床意义,以及与房颤复发的关系。方法:33例阵发性房颤患者和30例正常对照者入选,分别用放射免疫法、电化学发光免疫法、免疫比浊法测定术前、术后24h和术后3个月的ANP、NT-ProBNP和hs-CRP水平。结果:①房颤组基线血浆NT-ProBNP水平与对照组相比显著升高[(296.79±272.13):(80.81±69.13)μg/L,P=0.000],而血浆ANP和hs-CRP水平正常。术后房颤复发组的基线血浆NT-ProBNP水平较维持窦律组显著升高[(572.72±234.21):(176.82±188.73)μg/L,P=0.000]。②对13个变量如年龄、房颤史、超声参数、血浆ANP、NT-ProBNP和hs-CRP水平等进行Cox多元逐步回归,结果显示仅高的血浆NT-ProBNP水平是阵发性房颤患者肺静脉电隔离术后房颤复发的独立预测因子(χ2=20.986,P=0.000)。通过Kaplan-Meier分析,血浆NT-ProBNP水平≥423.20μg/L是房颤复发的重要危险因子(P=0.002)。结论:阵发性房颤患者血浆NT-ProBNP水平显著升高,升高的NT-ProBNP水平不仅可预测发生房颤的风险,还是早期预测房颤复发的生物标记物。
Objective: To investigate the changes of plasma ANP, NT-ProBNP and hs-CRP before and after pulmonary vein isolation in patients with paroxysmal atrial fibrillation (AF) The clinical significance of change, and the relationship with the recurrence of atrial fibrillation. Methods: Thirty-three patients with paroxysmal atrial fibrillation and 30 normal controls were enrolled. ANP, IL-6, IL-6 and IL-6 in preoperative and postoperative 24h and postoperative 3 months were measured by radioimmunoassay, NT-ProBNP and hs-CRP levels. Results: ①The baseline plasma NT-ProBNP level in AF group was significantly higher than that in the control group [(296.79 ± 272.13) :( 80.81 ± 69.13) μg / L, P = 0.000], while plasma ANP and hs-CRP levels were normal . The baseline NT-ProBNP level in postoperative atrial fibrillation recurrence group was significantly higher than that in sinus rhythm maintenance group [(572.72 ± 234.21) :( 176.82 ± 188.73) μg / L, P = 0.000]. ② Cox regression was performed on 13 variables such as age, atrial fibrillation history, ultrasound parameters, plasma ANP, NT-ProBNP and hs-CRP levels. The results showed that only high plasma NT-ProBNP levels were significantly higher in patients with paroxysmal atrial fibrillation Independent predictors of recurrence of atrial fibrillation after pulmonary vein isolation (χ2 = 20.986, P = 0.000). By Kaplan-Meier analysis, the plasma NT-ProBNP level of 423.20 μg / L was an important risk factor for the recurrence of atrial fibrillation (P = 0.002). CONCLUSIONS: Plasma NT-ProBNP levels are significantly elevated in patients with paroxysmal atrial fibrillation. Elevated NT-ProBNP levels predict not only the risk of atrial fibrillation but also the early prediction of atrial fibrillation recurrence.