血浆脑利钠肽与房颤病人复律和复发的临床研究

Plasma Brain Natriuretic Peptide in Patients with Paroxysmal Atrial Fibrillation

目的研究阵发性或持续性房颤（Af）病人转复窦性心律时，血浆脑利钠肽（BNP）水平及其临床意义。方法选取62例心功能（1-3）级病人，采用放免法测定房颤及窦性心律时病人血浆中BNP的浓度，观察两组BNP水平、房颤发作次数。结果病人房颤发生时BNP浓度为（88．36±22．32）pg／mL，比复律后窦性心律时（57．48±20．32）pg／mL明显增高（P〈0．05），高BNP水平病人组房颤发生次数较低BNP水平病人多。多因素分析显示血浆BNP水平与Af持续时间是转律后窦性心律维持的独立影响因子。结论血BNP浓度增高是发生心房颤动的预告因子，高水平的BNP更容易复发房颤，血浆BNP水平低或Af持续时间短者转律后窦性心律较易维持。

Objective To investigate the plasma concentration and clinical significance of brain natriuretic peptide （BNP） in the patients with paroxysmal atrial fibrillation. Methods Sixty - two patients with paroxysmal atrial fibrillation and cardiac function of grade 1 - 3 were enrolled, The plasma concentration during the episode of atrial fibrillation and sinus rhythm were measured by RIA technique. The difference between two groups was compared. The follow- up period was 12 months. The BNP level and the episode of atrial fibrillation were analyzed by logistic regression analysis. Results The plasma concentration of BNP in the episode of atrial fibrillation was higher than that during sinus rhythm. The level of BNP in the episode of atrial fibrillation and AF time were independent factors. Conclusion The plasma BNP was the predictor of the incurrence of atrial fibrillation. The patients with higher level of BNP were more predispose to the recurrence of atrial fibrillation. The sinus rhythm could be controlled easily in the patients with lower level of BNP and AF shorter persistent time.