急性阵发性房颤患者基线NT-proBNP对胺碘酮复律疗效的影响

The Effect of Baseline NT-proBNP on Amiodarone Cardioversion Efficacy in Patients With Acute Paroxysmal Atrial Fibrillation

目的 探讨N末端B型利钠肽原(N-terminal pro B-type natriuretic peptide,NT-proBNP)在胺碘酮用于急性阵发性房颤(acute atrial fibrillation,AF)复律疗效评估中的价值。方法纳入2019年2月—2022年7月三明市第二医院急诊科明确诊断为AF(非瓣膜病)的68例患者,所有患者排除禁忌后均给予胺碘酮复律治疗,根据复律后转复情况分为2组,即成功转复组(n=57)与转复失败组(n=11)。对比2组症状与体征(心悸、胸痛)、心电图表现(是否合并ST段压低)、既往病史(是否合并糖尿病、高血压病、冠心病等)、房颤持续时间和基线NT-proBNP水平。采用二元logistic回归分析AF患者胺碘酮复律疗效的影响因素。结果 2组胸痛、合并糖尿病、合并冠心病、ST段压低、房颤持续时间、合并高血压比较,差异无统计学意义(P>0.05)。成功转复组心悸发生率为28.07%、NT-proBNP水平为(229.43±7.24)pmol/L,优于转复失败组的63.64%、(679.99±8.67)pmol/L,差异有统计学意义(P<0.05)。入院时存在心悸症状、NT-proBNP是影响AF患者应用胺碘酮转复的主要因素(P<0.05)。结论 胺碘酮对AF(非瓣膜病)患者复律治疗安全有效,入院时存在心悸症状、基线NT-proBNP水平是预测胺碘酮复律成功的重要因素。

Objective To explore the assessed value of N-terminal pro B-type natriuretic peptide(NT-proBNP)for the efficacy of amiodarone in cardioversion of acute atrial fibrillation(AF).Methods A total of 68 patients diagnosed as AF(non-valvular disease)in the department of emergency,Sanming Second Hospital from February 2019 to July 2022 were included.All patients were given amiodarone reversion treatment after exclusion of contraindications,and were divided into two groups according to the status of reversion after reversion,namely successful cardioversion group(n=57)and failed cardioversion group(n=11).The symptoms and signs(palpitation,chest pain),electrocardiogram(ST segment depression or not),past medical history(diabetes,hypertension,coronary heart disease,etc.),duration of atrial fibrillation and baseline NT-proBNP level were compared between the two groups.The influencing factors of amiodarone relapse effect in AF patients were analyzed by binary logistic regression.Results There was no significant difference in chest pain,diabetes mellitus,coronary heart disease,ST-segment depression,duration of atrial fibrillation and hypertension between the two groups(P>0.05).In the successful cardioversion group,the incidence of palpitation was 28.07%,the level of NT-proBNP was(229.43±7.24)pmol/L.It was better than 63.64%,(679.99±8.67)pmol/L in the failed cardioversion group,and the difference was statistically significant(P<0.05).The presence of palpitations symptoms,NT-proBNP were the main factors affecting the use of amiodarone for conversion in AF patients(P<0.05).Conclusion Amiodarone is safe and effective foe the cardioversion treatment of AF(non-valvular disease)patients.The presence of palpitation symptoms on admission,baseline NT-proBNP level are important factors to predict the success of amiodarone cardioversion.