房颤患者胸腔镜下射频消融并左心耳切除对ANP分泌的影响

The effect of minimally invasive thoracoscopic left atrial appendage excision on ANP secretion in atrila fibrillation patients

目的 观察心房颤动（房颤）患者胸腔镜下射频消融并左心耳切除前、后血浆心钠素（又称心房利钠肽,ANP）水平变化,探讨该手术对心脏内分泌功能的影响.方法 阵发性房颤患者26例,成功施行外科微创治疗（胸腔镜辅助双侧肋间小切口行肺静脉射频消融隔离、左心耳切除及Marshall韧带离断）,分别于术前（房颤转复窦性心律后至少1天）、术后7天及术后3个月,抽取周围静脉血2 ml,酶标免疫法（ELISA）检测血浆中ANP含量并进行分析.结果 患者术前、术后7天、术后3个月时血浆内ANP浓度分别为（2.86±1.47） pg/ml、（2.83 ±1.08） pg/ml和（2.75±0.87） pg/ml.采用单因素重复测量设计的方差分析,球形检验P=0.008不满足球对称条件,故选用重复测量校正系数分析.患者术前、术后7天及术后3个月的血浆ANP浓度变化差异无统计学意义（P =0.801）.结论 胸腔镜下射频消融并左心耳切除治疗阵发性房颤对心房分泌ANP无明显影响,有利于增加治疗房颤的成功率,降低栓塞事件发生.

Objective The aim of the present study was to monitor the plasma levels of atrial natriuretic peptide（ANP） in patients accepting minimally invasive ablation.Methods The demographic and clinical data were collected from 26 consecutive patients with paroxysmal atrial fibrillation.Two milliliter of peripheral blood was harvested before operation,7 days and 3 months post-operation followed by ANP assay using ELISA kit.The repeated measurements were performed for each sample and One-way ANOVA was used for statistical analysis.Results Before operation,the ANP levels in plasma was （2.86 ±1.47） pg/ml.No significant changes of this ANP levels were observed 7 days and 3 months after operation,which were（2.83 ±1.08） pg/ml and（2.75 ±0.87） pg/ml,respectively.The Pvalue of sphericity Mauchly test was 0.008 for repeated measurements and for correction coefficient,P =0.801.Conclusion These findings suggest that the minimally invasive ablation and left appendage excision in patients with atrial fibrillation has no significant effect on atrial ANP secretion.