心房纤颤患者血浆TMAO、BNP及心房内径变化的意义

Significance of changes of plasma TMAO,BNP and atrial diameter in patients with atrial fibrillation

目的观察不同程度心房纤颤(房颤)患者血浆氧化三甲胺(TMAO)、B型利钠肽(BNP)水平与左心房内径(LAD)的变化,并探讨其与房颤病情严重程度的关系。方法选取2016年6月—2018年10月自贡市第一人民医院由心电图或动态心电图确诊为房颤患者160例为房颤组,其中阵发性房颤42例,持续性房颤54例,永久性房颤64例。另取同期体检的无房颤病史的健康者120例为健康对照组。比较2组研究对象血浆TMAO、BNP水平及LAD,并分析三者与房颤严重程度的相关性。结果与健康对照组相比,房颤组患者血浆TMAO、BNP显著增高,LAD显著增大,差异有统计学意义(t=-13.62、-26. 73、-4. 38,P均<0.01)。不同程度房颤患者随病情严重程度加重,TMAO、BNP水平及LAD增高,阵发性房颤亚组<持续性房颤亚组<永久性房颤亚组,差异有统计学意义(F=56. 94、216.32、12.401,P均<0.01)。血浆TMAO、BNP水平与LAD均呈正相关(r/P=0. 658/0. 003、0.679/0. 001)。结论房颤患者TMAO、BNP水平及左心房内径明显升高,并与房颤的严重程度有关。

Objective To observe the changes of plasma trimethylamine oxide(TMAO)and B-type natriuretic peptide(BNP)levels and left atrial diameter(LAD)in patients with different degrees of atrial fibrillation(AF),and to explore their relationship with the severity of AF.Methods One hundred and sixty patients with atrial fibrillation diagnosed by electrocardiogram or dynamic electrocardiogram in the First People’s Hospital of Zigong City from June 2016 to October 2018 were selected as atrial fibrillation group,including 42 cases of paroxysmal atrial fibrillation,54 cases of persistent atrial fibrillation and 64 cases of permanent atrial fibrillation.Another 120 healthy persons without history of atrial fibrillation were selected as healthy control group.The plasma levels of TMAO,BNP and LAD were compared between the two groups,and the correlation between them and the severity of atrial fibrillation was analyzed.Results Compared with healthy controls,plasma TMAO and BNP were significantly increased in patients with atrial fibrillation,and LAD was significantly increased(t=-13.62,t=-26.73,t=-4.38,P<0.01).Patients with different degrees of atrial fibrillation were aggravated with severity,TMAO,BNP levels and LAD increased,paroxysmal atrial fibrillation group<persistent atrial fibrillation group<permanent atrial fibrillation subgroup,the difference was statistically significant(F=56.94,F=216.32,F=12.401,P<0.01).Plasma TMAO and BNP levels were positively correlated with LAD(r/P=0.658/0.003,r/P=0.679/0.001).Conclusion The levels of TMAO,BNP and left atrial diameter were significantly increased in patients with atrial fibrillation,which was related to the severity of atrial fibrillation.