血浆B型脑钠肽对腹部手术患者术后心房颤动发生的预测价值

Predictive value of plasma type B brain natriuretic peptide on postoperative atrial fibrillation in patients undergoing abdominal surgery

目的通过对比进行普外科手术患者的血浆B型脑钠肽水平,研究脑钠肽与术后心房颤动(房颤)发生的关系。方法入选无房性心律失常病史,但有高血压病史、年龄≥50岁的行肝胆、胃肠手术患者115例,术后出现房颤33例为A组,未出现房颤82例为B组,对比A组与B组的脑钠肽及心脏超声指标。结果 A组与B组性别分布、左心室射血分数、左心房直径、室间隔厚度均无显著性差异。但A组年龄大于B组(P<0.05),A组的手术前、手术后第1天、第3天脑钠肽水平均较B组高,均有显著性差异(P均<0.05)。结论对于有高血压病史的中老年患者行普外科手术,血浆脑钠肽是预测术后房颤发生的较强而独立的因子。可术前使用β受体阻滞剂等抗心律失常类药物,以预防及减少术后房颤的发生。

Objective It is to study the relationship between brain natriuretic peptide and postoperative atrial fibrillation through compare the levels of plasma type B brain natriuretic peptide in patients undergoing general surgery operation.Methods 115 patients of age ≥50 years,with the history of hypertension,but no the atrial arrhythmia,who underwent the general surgery operation were chosen.33 patients with postoperative atrial fibrillation were in group A and 85 patients without postoperative atrial fibrillation were in group B.The brain natriuretic peptide and the indexes of heart ultrasound in the two groups were compared.Results There were no significant differences on sex distribution,left ventricular ejection fraction,left atrium diameter and interventricular septal thickness between the two groups.The age in group A was bigger than that in group B（P0.05）.The levels of brain natriuretic peptide preoperative,postoperative the first day and postoperative the third day in group A were all higher than that in group B（all P0.05）.Conclusion Plasma brain natriuretic peptide is a strong and independent predictor of postoperative atrial fibrillation for patients with the history of hypertension who underwent the general surgery operation.The preoperative application of the anti-arrhythmia drugs such as β-acceptor blocker can prevent beforehand and lessen the occurrence of postoperative atrial fibrillation.