心房颤动患者血清BNP、hsCRP、CK-MB的变化及意义

Variation and significance of serum BNP,hsCRP and CK-MB in patients with atrial fibrillation

目的探讨血清脑钠肽(brain natriuretic peptide,BNP)、高敏C-反应蛋白(high sensitive C-reactive protein,hsCRP)及肌酸激酶同工酶(MB isoenzyme of creatine kinase,CK-MB)在心房颤动(AF)患者血清中的浓度变化及临床意义。方法入选72例患者按照心电图诊断将其分为持续性房颤组(房颤组,n=32)和窦性心律组(窦律组,n=40),按照美国纽约心脏病学会(New York Heart Association,NYHA)心功能的分级标准,又分为心功能Ⅱ级、心功能Ⅲ级、心功能Ⅳ级3个亚组。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)、胶乳增强免疫透射比浊法、酶速率法分别测定BNP、hsCRP、CK-MB在各组血清中的浓度变化,对其结果进行统计分析。结果①房颤组血清BNP、hsCRP水平明显高于窦律组(P<0.05)。在相同心功能亚组中房颤组血清BNP、hsCRP水平明显高于窦律组(P<0.01)。在2组的心功能亚组中血清BNP、hsCRP水平随着心功能NYHA分级增加而增高(P<0.01)。②房颤组血清CK-MB水平与窦律组血清CK-MB水平无明显差别(P>0.05),其心功能亚组之间亦无明显差别(P>0.05)。③房颤组BNP、hsCRP、CK-MB 3者之间无相关关系(P>0.05)。结论BNP、hsCRP与心房颤动的发生和持续可能相关,可作为房颤病情的相对独立的检测指标。CK-MB与房颤的发生和发展可能无关。

Objective To explore the alterations and clinical significances of serum levels of brain natriuretic peptide （BNP）, high sensitive C-reactive protein （hsCRP）, MB jsoenzyme of creatine kinase （CK-MB） in patients with atrial fibrillation. Methods Totally 72 patients, including 32 with atrial fibrillation and 40 with sinus rhythm according to ECG were enrolled. The 2 groups were respectively further divided into 3 sub- groups （NYHA class Ⅱ , NYHA class Ⅲ and NYHA class Ⅲ ） according to the New York Heart Association （NYHA） cardiac function grading. Serum BNP, hsCRP, CK-MB levels in all patients were measured by en- zyme-linked immunosorbent assay （ELISA） , immunoturbidimetric method and enzyme rate assay. Results The serum levels of BNP and hsCRP in atrial fibrillation group were significantly higher than those in sinus rhythm group （ P 〈 0. 05 ）, the difference was even more significant among those from the same NYHA class subgroup （P 〈 0. 01 ）. In both atrial fibrillation group and sinus rhythm group, the serum levels of BNP and hsCRP were increased significantly in sequence with the NYHA class （P 〈 0.01 ）. There was no significant difference in serum CK-MB level either between atrial fibrillation group and sinus rhythm group, or in their sub- groups （P 〉 0.05）. No correlation was tbund in the serum levels of BNP, hsCRP and CK-MB levels in atrial fibrillation group （P 〉 0.05）. Conclusion BNP and hsCRP may be involved in the occurrence and sustain- ment of atrial fibrillation. The serum levels of BNP and hsCRP may serve as independent indexes of atrial fibrillation. CK-MB may be not involved in the incidence and development of atrial fibrillation.