脑钠肽对心力衰竭患者发生心房颤动的预测价值

Predictive value of B-type natriuretic peptide to atrial fibrillation in patients with heart failure

目的：通过测定心力衰竭（心衰）患者的血清脑钠肽（BNP）浓度，探讨BNP对心衰患者并发心房颤动（房颤）的预测价值。方法入选2010年7月至2013年12月在河南省安阳地区医院心内二科住院的心衰患者169例，152例完成随访，失访17例，其中男性79例，女性73例，年龄37-71岁，平均年龄（48±11）岁，根据随访结果将患者分为两组，房颤组（n=29）和窦性心律组（n=123）。所有患者在入选前以及随访1年均行Holter检查，同时检测患者血清BNP水平。结果随访1年后，152例患者完成随访，其中有29例患者记录到房颤。房颤组[（312.21±52.78）pg/ml]BNP水平明显高于窦性心律组[（218.24±67.45）pg/ml]，差异具有统计学意义（P＜0.01）。多因素分析结果显示，年龄OR值为4.162，95％CI：1.521-7.132；LVEF OR值为1.027，95％CI：0.939-1.058。年龄和左室射血分数（LVEF）是心衰患者并发房颤的独立危险因素。结论血清BNP水平对心衰患者是否发生房颤有重要的预测价值。

Objective To investigate the predictive value of B-type natriuretic peptide （BNP） to atrial fibrillation （AF） in patients with heart failure through detecting the level of serum BNP level. Methods The patients （n=169） were chosen from Jul. 2010 to Dec. 2013 and among them, 17 were missed and 152 were followed up. There were 79 male patients and 73 female ones aged from 37 to 71, and average age was （48±11） years old. All patients were divided, according to follow-up results, into AF group （n=29） and sinus rhythm group （n=123）. All patients were given Holter test before chosen and after followed up for 1 y, and at the same time BNP level was detected. Results After 1 y, 152 patients completed follow-up and AF was recorded in 29 patients. BNP level was significantly higher in AF group [（312.21±52.78） pg/mL] than that in sinus rhythm group [（218.24±67.45） pg/mL, P〈0.01]. The results of multi-factor analysis showed that age （OR=4.162, 95%CI：1.521-7.132） and LVEF （OR=1.027, 95%CI：0.939-1.058） were independent risk factors of heart failure complicating AF. Conclusion The level of serum BNP is important to the prediction of AF in patients with heart failure.