【摘要】 目的探讨非瓣膜性心脏病阵发性心房颤动(房颤)患者药物复律前血浆N末端脑钠肽前体水平对复律效果的预测价值。方法98例非瓣膜性心脏病阵发性房颤患者接受顿服普罗帕酮450～600mg复律治疗,观察患者复律前后血浆N末端脑钠肽前体(NT-proBNP)水平变化。结果98例阵发性房颤患者顿服普罗帕酮后48h内57例(58.2%)转复为窦性心律,成功复律组患者复律前血浆NT-proBNP水平为(435.65±156.27)ng/L,明显低于未成功复律组的(482.76±59.86)ng/L,(P<0.01),成功复律组患者复律后1h血浆NT-proBNP水平为(195.61±36.38)ng/L,明显低于复律前的(435.65±156.27)ng/L,(P<0.01),而未成功复律组复律前血浆NT-proBNP为(482.76±59.86)ng/L,与服药后48h的(453.76±143.38)ng/L无明显变化(P>0.05)。结论房颤本身是影响心肌细胞脑钠肽分泌的重要因素,入院时血浆NT-proBNP水平对非瓣膜性心脏病阵发性房颤药物复律效果具有预测价值。更多还原

【Abstract】 Objective To investigate the value of plasma NT-proBNP levels in predicting the effect of drug conversion for paroxysmal atrial fibrillation.Method The 98 patients with monvalvular paroxysmal atrial fibrillation were treated by oral loading-dose of propafenon(450 ～600ng/L) within 1 h after admission.The plasma NT-proBNP concentrations were mearsured before and after conversion therapy.Result Atrial fibrillation was conversed to sinus rhythm in 57 patients(58.2%) after oral loading-dose of propafenone.The plasma NT-proBNP levels before drug conversion in patients with successful conversion were lower than that in patients with non-successful conversion(435.65±156.27)ng/L vs(482.76±59.86) ng/L,P<0.01;and it was decreased significantly after successful drug conversion(195.61±36.38)ng/L vs(435.65 ±156.27)ng/L,P <0.01.There was no significant difference of plasma NT-proBNP concentration before and after propefenone treatment(482.76±59.86)ng/L vs(453.76±143.38)ng/L(P>0.05) in patients non-conversed to sinus rhythum.Conclusion Atrial fibrillation is a significant factor influencing the secretion of BNP in patient with nonvalvular heart disease and plasma NT-proBNP levels can be used as a biomarker to predict the effect of drug conversion for paroxysmal atrial fibrillation.更多还原