不同类型心房颤动患者心房钠尿肽水平及相关因素研究

Atrial natriuretic peptide level and related factors in patients with different types of atrial fibrillation

摘要:

目的：比较不同类型心房颤动（artial fibrillation, AF）患者血浆心房钠尿肽（atrial natriuretic peptide, ANP）水平的差异，分析影响患者血浆ANP水平的相关因素。方法：入选35名阵发性AF患者、30名持续性AF患者和30名非AF患者为研究对象。详细记录患者基线资料、生化指标及经胸超声心动图检查（the thoracic echocardiography，TTE）等指标，测定血浆ANP水平，分析ANP水平与心率、超声指标的关联，明确AF发作或持续时间与ANP水平的关系。结果：AF患者ANP水平明显高于非AF患者（P<0.05），与AF时心率正相关（r=0.386，P=0.000）。阵发性AF患者AF时ANP水平显著高于窦性心律时（t=4.040，P=0.001），且与AF持续时间明显正相关（r=0.742，P=0.000）；而持续性AF患者ANP水平与AF持续时间未见明显相关性（r=0.386，P=0.000）。持续性AF患者左心房内径（left atrial diameter，LAD）、右心室舒张末期内径（right ventricular end diastolic diameter，RVDd）明显高于阵发性AF（P=0.000 vs. P=0.013）和非AF（P=0.000 vs. P=0.023）患者；阵发性AF患者LAD亦明显高于非AF患者（P=0.000）。但未见ANP水平与超声指标间存在明显相关性（P>0.05）。结论：AF患者血浆ANP水平升高，且ANP水平与AF时心率、持续时间等因素相关，与AF类型、超声指标不相关。

Abstract:

Objective：To compare plasma atrial natriuretic peptide（ANP） levels in patients with different types of artial fibrillation（AF） and to analyze the related factors. Methods：The clinical data of 35 patients with paroxysmal AF，30 patients with persistent AF and 30 patients without AF were collected in this research. Baseline data，biochemical indicators，and ultrasonic cardiogram indexes were recorded. The correlation between the plasma levels of ANP in patients with different types of AF and the cardiac ultrasound indexes were analyzed. Results：At admission，the ANP levels in AF patients were significantly higher than those insinus rhythm（P<0.05），and positive correlation was observed between ANP level and their heart rates during AF（r=0.386，P=0.000）. For paroxysmal AF patients the level of ANP was significantly higher during AF than sinus rhythm（P=0.001），and positive correlation was observed between ANP level and the duration of AF（r=0.742，P=0.000）. But no correlation was shown between ANP level and the duration of AF in patients with persistent AF（r=0.386，P=0.000）. The LAD，RVDd in persistent AF patients was significantly larger than those of paroxysmal AF patients（P=0.000 vs. P=0.013） and those without AF（P=0.000 vs. P=0.023），and the LAD in paroxysmal AF group was significantly larger than that those without AF（P=0.000）. No correlation was shown between ANP level and ultrasonic cardiogram indexes of AF. Conclusion：The plasma ANP levels in AF patients are high. Notably correlation is shown between heart rates，duration of AF，and plasma ANP level. No correlation is shown between the duration of AF，ultrasonic cardiogram indexes and plasma ANP level.