和肽素与急性心肌梗死后新发心房颤动相关性的研究

Clinical study of the relationship between Copeptin and new-onset atrial fibrillation in patients with acute myocardial infarction

目的 探讨和肽素（Copeptin）与急性心肌梗死（AMI）合并新发心房颤动（new-onset atrial fib-rillation）的关系.方法 随机连续入选急性心肌梗死患者228例,入院时抽取肘静脉血,采用ELASE法测定和肽素浓度,持续监测住院7d内有无心房颤动的发生.根据是否发生心房颤动分成心房颤动组和非心房颤动组,记录两组患者的一般临床情况,测定和肽素水平,并进行统计学分析.结果 心房颤动组和肽素浓度高于非心房颤动组（21.2 pmol/L比9.6 pmol/L,P〈0.05）.多变量Logistic逐步回归表明,入院时心率（OR=1.059,95%CI 0.999-1.123,P=0.042）、和肽素（OR=4.685,95%CI 1.729-12.692,P=0.002）、左心房内径（LAD）（OR=1.204,95%CI 1.069-1.355,P=0.002）是预测AMI新发房颤的危险因素.结论 和肽素水平是预测AMI后新发房颤的有效指标.

Objective To explore the correlation between C-terminal portion of provasopressin（Copeptin） and new-onset atrial fibrillation in patients with acute myocardial infarction （AMI）. Methods We selected 228 subjects with acute myocardial infarction （AMI）. All patients were monitored continuously for new-onset atrial fib-rillation （AF）for 7 days since admission. All patients were divided into a group with new-onset AF and a group without new-onset AF. Admission plasma Copeptin was measured by enzyme-linked immunosorbent assay（ELISA）. Results The admission plasma levels of Copeptin in new-onset AF group were higher than the without new -onset AF （21.2 pmol/L vs 9.6 pmol/L,P〈0.05）. Multivariate logistic regression analysis revealed that admission heart rate（OR=1.059,95%CI 0.999-1.123,P=0.042）,Copeptin levels（OR=4.685,95%CI 1.729-12.692,P=0.002）, left atrial diameter（LAD）（OR=1.204,95%CI 1.069-1.355,P=0.002）were significantly and independently associ-ated with new-onset AF in patients with AMI. Conclusion Copeptin levels are effective predictor of new-onset AF in patients with AMI.