心房颤动患者血浆脑利钠肽的变化及意义

Changes of plasma brain natriuretic peptide and its clinical significance in patients with atrial fibrillation

目的探讨脑利钠肽（BNP）水平与阵发性心房颤动（房颤）和持续性房颤、瓣膜性房颤和非瓣膜性房颤的关系。方法选择2005年10月至2007年1月在内蒙古医学院附属医院就诊的心脏病患者158例，其中房颤组83例，无房颤组75例。以NYHA心功能分级评价心功能，采用双单克隆抗体微粒子酶免疫法测定血浆BNP水平。采用病例对照研究进行统计分析。结果在心功能相同时，房颤组的BNP浓度为（112±75）ng／L，显著高于无房颤组[（39±26）ng／L，P〈0．05]。阵发性房颤患者的BNP浓度为（113±84）ng／L，与持续性房颤患者的BNP浓度[（110±69）ng／L]差异无统计学意义；瓣膜性房颤患者的BNP浓度为（84±73）ng／L，与非瓣膜性房颤患者的BNP浓度[（117±76）ng／11差异也无统计学意义。结论房颤患者血BNP水平升高。在心功能相同的情况下，阵发性与持续性房颤、瓣膜性与非瓣膜性房颤的BNP水平差异均无统计学意义。

Objective To study the changes of plasma brain natriuretic peptide （BNP） level in patients with atrial fibrillation （AF）, and explore the relationship between plasma level of BNP and paroxysmal AF, persistent AF, rheumatic AF and non-rheumatic AF. Methods In total, 158 outpatients and inpatients diagnosed as heart diseases were selected from the Affiliated Hospital of Inner Mongolia Medical College during October 2005 to January 2007, 83 with AF and 75 without AF. Their cardiac function was evaluated according to the classification system of the New York Heart Association （NYHA） in the United States. Plasma level of BNP was measured with bi-monoclonal antibody microparticulate enzyme immunoassay （MEIA）. Results Plasma BNP level was significantly higher in AF group [ （112 ± 75 ）ng/L] than that in non-AF group [ （39 ± 26） ng/L, P 〈 0. 05 ] with same ventricular function. No significant difference in plasma level of BNP between the groups with paroxysmal AF [ （113 ± 84） ng/L] and with persistent AF [ （ 110 ± 69 ） ng/L] was found. Plasma level of BNP was （ 84 ± 73 ） ng/L in the group with rheumatic valvular AF, not significantly different from that in non-valvular AF [ （117 ± 76 ） ng/L , P 〉 0. 05 ]. Conclusion Plasma BNP level is higher in AF group than that in non-AF group, but no significant difference in plasma BNP level between patients with paroxysmal AF, persistent AF, rheumatic valvular AF and non-rheumatic AF, under same ventricular function, was found.