【摘要】 目的:研究房颤合并肺动脉高压(PAH)患者的临床特点及危险因素。方法:依据漂浮导管检查，140例房颤患者被分为PAH组(74例)和正常肺动脉压(NPAP)组(66例)。比较两组临床指标，并分析房颤合并PAH的危险因素。结果:与NPAP组比较，PAH组血浆N基末端脑钠肽前体(NT-proBNP)、内皮素(ET)-1、白介素(IL)-6、肿瘤坏死因子(TNF)-α水平、血清甘油三酯、LDL-C水平、超声心动图指标：LAAD、RVD、LVEDd,右心导管检查指标：mRAP、mRVP、mPAP、SPAP、PCWP均显著升高，血清HDL-C水平、LVEF均显著降低(P<0.05或<0.01)。二元Logistic回归分析显示，NT-proBNP、ET-1、IL-6、TNF-α为房颤合并PAH的独立危险因素(OR=1.016～1.882,P<0.05或<0.01)。ROC曲线分析显示，NT-proBNP、ET-1、IL-6、TNF-α预测房颤合并PAH的曲线下面积分别为0.969、0.985、0.990、0.954;截断值分别为1042.50ng/L、11.75mg/L、63.25ng/L、157.10mmol/L,灵敏度分别为90.5%、93.2%、100.0%、94.6%,特异度分别为97.0%、97.0%、90.9%、87.9%。结论:NT-proBNP、ET-1、IL-6、TNF-α为房颤合并肺动脉高压的独立危险因素，具有一定预测价值。更多还原

【Abstract】 Objective: To study clinical characteristics and risk factors of patients with atrial fibrillation(AF) complicated pulmonary artery hypertension(PAH). Methods:According to floating catheter examination, a total of 140 AF patients were divided into PAH group(n=74) and normal pulmonary arterial pressure(NPAP) group(n=66). Clinical indexes were compared between two groups, and risk factors of AF+PAH were analyzed. Results: Compared with NPAP group, there were significant rise in plasma levels of N-terminal pro-brain natriuretic(NT-proBNP), endothelin(ET)-1, interleukin(IL)-6 and tumor necrosis factor(TNF)-α, serum levels of triglyceride and LDL-C, echocardiographic indexes: LAAD, RVD and LVEDd, right heart catheterization indexes: mRAP, mRVP, mPAP, SPAP and PCWP, and significant reductions in plasma level of HDL-C level and LVEF in PAH group(P<0.05 or <0.01). Binary Logistic regression analysis indicated that NT-proBNP, ET-1, IL-6 and TNF-α were independent risk factors for AF+PAH(OR=1.016～1.882, P<0.05 or <0.01). ROC curve analysis indicated that areas under curve of NT-proBNP, ET-1, IL-6 and TNF-α for predicting AF+PAH was 0.969, 0.985, 0.990 and 0.954 respectively; cutoff points of them was 1042.50 ng/L, 11.75 mg/L, 63.25 ng/L and 157.10 mmol/L respectively; sensitivities of them was 90.5%, 93.2%, 100.0% and 94.6% respectively; and specificities of them was 97.0%, 97.0%, 90.9% and 87.9% respectively. Conclusion:NT-proBNP, ET-1, IL-6 and TNF-α are independent risk factors for atrial fibrillation complicated pulmonary artery hypertension, and possesses certain predictive value.更多还原