N-末端脑利肭肽与心衰并房颤患者复律问题的研究

Study on relationship between NT-BNP and cardioversion of patient with heart failure combined with atrial fibrillation

目的研究心衰并心房颤动的心脏病患者胺碘酮复律前血浆N-末端脑钠肽前体水平对复律效果的预测价值。方法150例心衰并心房颤动的心脏病患者接受静脉滴注胺碘酮5～7mg／kg，30～60min内滴完，复律治疗，观察患者复律前后血浆N末端脑钠肽前体（NT-proBNP）水平变化。结果150例阵发性房颤患者服药后48h内100例（66．67％）转复为窦性心律，成功复律组患者复律前血浆NT-proBNP水平为（967．04±366．16）ng／L，明显低于未成功复律组（1182．04±298．34）ng／L（P〈0．01）；成功复律组患者复律后1h血浆NToproBNP水平为（496．21±142．54）ng／L，明显低于复律前（967．04±366．16）ng／L（P〈0．01）；而未成功复律组血浆NT-proBNP水平复律前（1182．04±298．34）ng／L，与服药后48h（996．76±351．28）ng／L比较无明显变化（P〈0．05）。结论人院时血浆NT-proBNP水平对心衰并心房颤动的心脏病患者药物复律效果具有预测价值。

Objective Before cardioversion with Amiodarone in patient with heart failure（HF） combined with atrial fi- brillation（AF） ,to make a study about the predictive value of NT-pro BNP level for cardioversion effect. Methods To observe the level changes of NT-pro BNP of 160 patients with I-IF combined with AF between before and after cardioversion with intravenous Amiodarone 5-7 mg/kg,dropping over with in 30 to 60 minutes. Result After 150 cases with paroxysmal taking drug, within 48 hours, 100 patients （66.67% ） converted sinus rhythm, before cardio- version, plasma NT-pro BNP level about successful cardioerter groups was （967.04±366.16） ng/L,obviously lower than unsuccessfully cardioerter group（ 1 182.04± 298.34 ） ng/L （ P〈0.01 ）, after cardioversion for 1 hour, plasma NT-pro BNP level of successful cardioerter groups was （496. 21± 142. 54） ng/L, obviously lower than before （967.04± 366.16） ng/L（P〈0.01 ）,before cardioversion, but plasma NT-pro BNP level of unsuccessful group was （1 182.04±298.34） ng/L,Compared with after medication for 48 hours（996. 76±351.28） ng/L,had no change（P 〈0. 05）. Conclusion Plasma NT-pro BNP level has forecast values for drug cardioversion effect in hospitalized patients with HF combined with AF.