心房颤动患者血浆心房钠尿肽与C型钠尿肽浓度的变化

The concentration changes of plasma atrial natriuretic peptide and C-type natriuretic peptide in patients with atrial fibrillation

目的观察心房颤动(简称房颤)患者血浆心房钠尿肽(ANP)和C型钠尿肽(CNP)水平的变化,及其与心脏结构改变的相关性,从而进一步分析ANP、CNP在房颤心房结构重构中的作用。方法入选左心功能正常的房颤患者及无房颤对照组。房颤患者又根据房颤持续时间不同分为阵发性房颤(Paf)组及持续性房颤(Peaf)组。采用酶联免疫吸附法检测血浆ANP和CNP水平,并采用超声心动图测量舒张期左房内径、左室内径、室间隔厚度及左室后壁厚度,并计算左室质量指数。结果入选对照组57例,和房颤组62例(其中Paf组35例,Peaf组27例)。年龄、性别等临床背景资料均无差异,具有可比性。房颤组的血浆ANP和CNP水平明显高于对照组[ANP:(728.1±336.9)pg/ml vs(524.6±165.3)pg/ml,P=0.000;CNP:(114.2±28.6)pg/ml vs(97.1±22.4)pg/ml,P=0.000],且与左房内径明显正相关(ANP:r=0.389,P=0.001;CNP:r=0.344,P=0.004)。此外,ANP与CNP之间呈明显的相关性(r=0.799,P=0.000),CNP与室间隔厚度(r=0.343,P=0.006)、左室后壁厚度(r=0.308,P=0.013)、左室质量指数(r=0.275,P=0.030)相关。结论 ANP和CNP与左房扩大明显相关,可能参与心脏重构的过程。

Objective To observe the levels of atrial natriuretic peptide （ANP） and C-type natriuretic peptide （CNP） in patients with atrial fibrillation （AF）, and to explore the relationship between plasma ANP,CNP levels and the change of cardiac structure, to explain the role of ANP and CNP in the atrial structure remodeling of AF. Methods We enrolled patients with normal cardiac function in AF group and control group. The plasma levels of ANP and CNP were detected with enzyme-linked immunosorbent assay （ELISA）. The left atrial dimension, left ventricular dimension, interventricular septal thickness and left ventricular posterior wall thickness and left ventricular mass index were determined by echocardiogram. Using SPSS 20.0 software to count and analyze data. Results One hundred and ninteen patients were enrolled including 62 AF patients in AF group and 57 patients without AF in control group. No significance were found in age, sex, BMI, plasma free glucose, lipid, the function of liver and kidney. Compared with the control group, the plasma levels of ANP and CNP were higher in the AF groupEANP： （728.1±336.9） pg/ml vs （524.6±165.3） pg/ml, P=0.000; CNP： （114. 2±28.6） pg/ml vs （97.1±22.4） pg/ml, P=0. 000], and LAD had positive correlation with ANP and CNP （ANP= r=0. 389, P=0. 001 ; CNP： r=0. 344, P = 0. 004）. Additionally, ANP has positive correlation with CNP （r= 0. 799, P〈0. 001）, and CNP was associated with inter-ventricular septal thickness （ r= 0.343, P = 0.006）, left ventricular posterior wallthickness （ r= 0.308,P=0. 013） , left ventricular mass index（r=0. 275, P = 0. 030）. Conclusion ANP and CNP have a association with left atrial enlargement and probably par ticipate in the occurrence and development of cardiac remodeling.