血尿酸、脑钠肽对主动脉瓣置换术后房颤发生的预测分析

Predictive analysis of blood uric acid and brain natriuretic peptide on the occurrence of atrial fibrillation after aortic valve replacement surgery

目的:分析血尿酸、脑钠肽(Brain Natriuretic Peptide,BNP)对主动脉瓣置换术后房颤发生的预测价值。方法:选择2020年1月至2023年8月期间在南阳市中心医院拟行主动脉瓣置换术治疗的117例患者作为研究对象,以术后2 w内房颤发生情况作为观察终点并将患者分为发生组与未发生组。采集并比较两组患者一般资料及实验室指标,测定两组术前血尿酸、BNP水平,并分析血尿酸、BNP水平对主动脉瓣置换术后房颤发生的预测价值。结果:发生组左房容积、血尿酸、BNP水平均高于未发生组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,左房容积增加、血尿酸及BNP水平升高是主动脉瓣置换术后房颤发生的危险因素(OR>1,P<0.05);绘制受试者工作特征曲线,结果显示血尿酸、BNP及联合对主动脉瓣置换术后房颤发生预测的曲线下面积均>0.7,预测价值较好,且以联合预测性能最佳。结论:血尿酸、BNP水平异常高表达可能会增加主动脉瓣置换术后房颤发生风险,联合检测两种指标水平或可提高对术后房颤发生的预测价值。

Objective:To analyze the predictive value of blood uric acid and brain natriuretic peptide(BNP)in the occurrence of atrial fibrillation after aortic valve replacement surgery.Method:117 patients who planned to undergo aortic valve replacement surgery at Nanyang Central Hospital from January 2020 to August 2023 were selected as the study subjects.The incidence of atrial fibrillation within 2 weeks after surgery was observed as the endpoint,and the patients were divided into occurrence and nonoccurrence groups.The general data and laboratory indexes of the two groups were collected and compared.The levels of blood uric acid and BNP were measured before operation,and the predictive value of blood uric acid and BNP levels on the occurrence of atrial fibrillation after aortic valve replacement was analyzed.Results:The left atrial volume,blood uric acid,and BNP levels in the occurrence group were higher than those in the non-occurrence group,with a statistical significant difference(P<0.05).The results of Logistic regression analysis showed that an increase in left atrial volume,blood uric acid,and BNP levels were risk factors for atrial fibrillation after aortic valve replacement surgery(OR>1,P<0.05).Receiver operating characteristic curve(ROC)was drawn,and the results showed that the area under the curve(AUC)of blood uric acid,BNP and the combination for predicting the occurrence of atrial fibrillation after aortic valve replacement were all greater than 0.7,which showed good predictive value,and the combination had the best predictive performance.Conclusion:Abnormally high levels of uric acid and BNP may increase the risk of atrial fibrillation after aortic valve replacement,and the combined detection of these two indicators may improve the predictive value of postoperative atrial fibrillation.