非瓣膜病性心房颤动患者血清高敏C-反应蛋白、脑钠肽、内皮素-1水平的测定及其临床意义

Clinical Significance of Serum High-Sensitive C-Reactive Protein,Brain Natriuretic Peptide,Endothelin-1 in Patients with Nonvalvular Atrial Fibrillation

目的探讨不同类型非瓣膜病性心房颤动（AF）患者血清高敏C-反应蛋白（hs-CRP）、脑钠肽（BNP）、内皮素-1（ET-1）的水平差异及其在AF发生、维持及血栓栓塞事件中的作用。方法入选114例纽约心脏病协会（NYHA）心功能Ⅰ~Ⅱ级、左室射血分数〉50%的AF患者,其中慢性AF患者（慢性AF组）52例、阵发性AF患者（阵发性AF组）62例,同时选择性别、年龄、病情等与之相匹配的窦性心律患者（窦性心律组）48例,测定血清hs-CRP、BNP、ET-1水平并进行统计分析。结果两组AF患者血清hs-CRP、BNP、ET-1水平均高于窦性心律组,差异有统计学意义（P〈0.05）。慢性AF组hs-CRP、BNP水平高于阵发性AF组,差异有统计学意义（P〈0.05）;慢性AF组ET-1水平较阵发性AF组有升高趋势,但差异无统计学意义（P〉0.05）。结论 AF患者血清hs-CRP、BNP、ET-1水平升高,且慢性AF患者升高明显;hs-CRP、BNP、ET-1可能对AF的发生、维持、血栓栓塞风险有一定的预测作用,及时有效的预防和治疗可能会减少AF的发生、有益于窦性心律的维持、降低血栓栓塞事件的风险。

Objective To investigate the changes of serum high-sensitive C-reactive protein（hs-CRP）,brain natriuretic peptide（BNP）,endothelin-1（ET-1）concentrations in patients with nonvalvular atrial fibrillation（AF） and their contributions to the risk of thrombembolia.Methods Totally 114 AF patients whose cardiac function was Ⅰ orⅡ grade and left ventricular ejection fraction（LVEF）50% according to the criteria of New York Heart Academy（NYHA） were recruited,among them 52 patients had to chronic AF,and 62 had paroxysmal AF.And another 48 patients with sinus rhythm,whose sex,age and condition were matched with the AF patients,were enrolled.The levels of hs-CRP,BNP,and ET-1 measured and statistically analyzed.Results The serum levels of hs-CRP,BNP,and ET-1 in the two AF groups were higher than those in the sinus rhythm group（P0.05）.The serum levels of hs-CRP and BNP were much higher in the chronic AF group than those in the paroxysmal AF group（P0.05）.The serum ET-1 level in the chronic AF group was higher than that in the paroxysmal AF group,but no statistical significance was found（P0.05）.Conclusion The levels of serum hs-CRP,BNP,and ET-1 in AF patients,especially in chronic AF patients.They may be of a certain predictive significance for the occurrence and maintenance of AF as well as the risk of thrombembolia.The effective prevention and treatment might decrease the occurrence of AF,be beneficial to the maintenance of sinus rhythm,and decrease the risk of thrombembolia.