中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
13期
1-4
,共4页
冠状动脉疾病%心房颤动%血栓形成%利钠肽,脑
冠狀動脈疾病%心房顫動%血栓形成%利鈉肽,腦
관상동맥질병%심방전동%혈전형성%리납태,뇌
Coronary artery disease%Atrial fibrillation%Thrombosis%Natriuretic peptide,brain
目的 评估血浆N末端B型利钠肽前体(NT-proBNP)对冠心病(CHD)合并心房颤动(AF)患者发生心房附壁血栓的临床预测价值.方法 回顾性分析124例CHD合并AF患者的临床资料,根据有无心房附壁血栓分为研究组60例(发生心房附壁血栓),对照组64例(未发生心房附壁血栓).检测并比较两组的血浆NT-proBNP、空腹血糖(FPG)、餐后2h血糖(2 h PG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、氧化型低密度脂蛋白(ox-LDL)、高敏C反应蛋白(hs-CRP)水平以及心脏超声指标左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、左房内径(LAD)的差异.应用全模型多元Logistic回归分析上述指标与患者心房附壁血栓发生的相关性,应用受试者工作特征曲线(ROC曲线)分析NT-proBNP对心房附壁血栓发生的最佳预测值.结果 研究组NT-proBNP、ox-LDL、hs-CRP、LVEDd、LAD水平高于对照组[(4 312.6±209.1)pmol/L比(3 421.6±156.8) pmol/L、(4.0±0.9)mmol/L比(3.4 ±0.8) mmol/L、(7.4±1.3) mg/L比(5.8±1.0) mg/L、(74.3±6.8) mm比(58.1±5.5) mm、(39.6±4.3) mm比(32.5±3.8) mm],LVEF、HDL-C水平低于对照组[(48.2±3.1)％比(57.3±3.8)％、(0.72±0.16) mmol/L比(1.08±0.27) mmol/L],差异均有统计学意义(P＜0.05);而两组FPG、2hPG、TC水平比较差异无统计学意义(P＞0.05).全模型多元Logistic回归分析显示,NT-proBNP与LAD为CHD合并AF患者发生心房附壁血栓的独立预测因子(P=0.009,0.028).NT-proBNP＞4 250 pmol/L患者与NT-proBNP≤4 250 pmol/L患者心房附壁血栓发生率比较差异有统计学意义(P=0.028).结论 NT-proBNP能独立预测CHD合并AF患者心房附壁血栓的发生.
目的 評估血漿N末耑B型利鈉肽前體(NT-proBNP)對冠心病(CHD)閤併心房顫動(AF)患者髮生心房附壁血栓的臨床預測價值.方法 迴顧性分析124例CHD閤併AF患者的臨床資料,根據有無心房附壁血栓分為研究組60例(髮生心房附壁血栓),對照組64例(未髮生心房附壁血栓).檢測併比較兩組的血漿NT-proBNP、空腹血糖(FPG)、餐後2h血糖(2 h PG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、氧化型低密度脂蛋白(ox-LDL)、高敏C反應蛋白(hs-CRP)水平以及心髒超聲指標左室射血分數(LVEF)、左室舒張末期內徑(LVEDd)、左房內徑(LAD)的差異.應用全模型多元Logistic迴歸分析上述指標與患者心房附壁血栓髮生的相關性,應用受試者工作特徵麯線(ROC麯線)分析NT-proBNP對心房附壁血栓髮生的最佳預測值.結果 研究組NT-proBNP、ox-LDL、hs-CRP、LVEDd、LAD水平高于對照組[(4 312.6±209.1)pmol/L比(3 421.6±156.8) pmol/L、(4.0±0.9)mmol/L比(3.4 ±0.8) mmol/L、(7.4±1.3) mg/L比(5.8±1.0) mg/L、(74.3±6.8) mm比(58.1±5.5) mm、(39.6±4.3) mm比(32.5±3.8) mm],LVEF、HDL-C水平低于對照組[(48.2±3.1)％比(57.3±3.8)％、(0.72±0.16) mmol/L比(1.08±0.27) mmol/L],差異均有統計學意義(P＜0.05);而兩組FPG、2hPG、TC水平比較差異無統計學意義(P＞0.05).全模型多元Logistic迴歸分析顯示,NT-proBNP與LAD為CHD閤併AF患者髮生心房附壁血栓的獨立預測因子(P=0.009,0.028).NT-proBNP＞4 250 pmol/L患者與NT-proBNP≤4 250 pmol/L患者心房附壁血栓髮生率比較差異有統計學意義(P=0.028).結論 NT-proBNP能獨立預測CHD閤併AF患者心房附壁血栓的髮生.
목적 평고혈장N말단B형리납태전체(NT-proBNP)대관심병(CHD)합병심방전동(AF)환자발생심방부벽혈전적림상예측개치.방법 회고성분석124례CHD합병AF환자적림상자료,근거유무심방부벽혈전분위연구조60례(발생심방부벽혈전),대조조64례(미발생심방부벽혈전).검측병비교량조적혈장NT-proBNP、공복혈당(FPG)、찬후2h혈당(2 h PG)、총담고순(TC)、고밀도지단백담고순(HDL-C)、양화형저밀도지단백(ox-LDL)、고민C반응단백(hs-CRP)수평이급심장초성지표좌실사혈분수(LVEF)、좌실서장말기내경(LVEDd)、좌방내경(LAD)적차이.응용전모형다원Logistic회귀분석상술지표여환자심방부벽혈전발생적상관성,응용수시자공작특정곡선(ROC곡선)분석NT-proBNP대심방부벽혈전발생적최가예측치.결과 연구조NT-proBNP、ox-LDL、hs-CRP、LVEDd、LAD수평고우대조조[(4 312.6±209.1)pmol/L비(3 421.6±156.8) pmol/L、(4.0±0.9)mmol/L비(3.4 ±0.8) mmol/L、(7.4±1.3) mg/L비(5.8±1.0) mg/L、(74.3±6.8) mm비(58.1±5.5) mm、(39.6±4.3) mm비(32.5±3.8) mm],LVEF、HDL-C수평저우대조조[(48.2±3.1)％비(57.3±3.8)％、(0.72±0.16) mmol/L비(1.08±0.27) mmol/L],차이균유통계학의의(P＜0.05);이량조FPG、2hPG、TC수평비교차이무통계학의의(P＞0.05).전모형다원Logistic회귀분석현시,NT-proBNP여LAD위CHD합병AF환자발생심방부벽혈전적독립예측인자(P=0.009,0.028).NT-proBNP＞4 250 pmol/L환자여NT-proBNP≤4 250 pmol/L환자심방부벽혈전발생솔비교차이유통계학의의(P=0.028).결론 NT-proBNP능독립예측CHD합병AF환자심방부벽혈전적발생.
Objective To analyze the predictive value of N-terminal B-type natriuretic peptide precursor(NT-proBNP) on auricular thrombosis in patients of coronary heart disease (CHD) combined with atrial fibrillation (AF).Methods The clinical data of 124 patients of CHD combined with AF were analyzed retrospectively.All patients were divided into research group (60 cases,compliance with auricular thrombosis) and control group (64 cases,non-compliance with auricular thrombosis),according to the occurrence of auricular thrombosis.The values of NT-proBNP,fasting plasma glucose (FPG),postprandial plasma glucose(2 h PG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),oxidized low density lipoprotein (ox-LDL),high sensitivity C reactive protein (hs-CRP) and left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDd) and left atrial diameter (LAD) were detected and compared between two groups.The relative factors to the occurrence of auricular thrombosis were confirmed by multivariate Logistic analysis.The best cutoff point of NT-proBNP was confirmed by the areas under the receiver operating characteristic curve (ROC).Results The values of NT-proBNP,ox-LDL,hs-CRP,LVEDd and LAD in research group were higher than those in control group [(4 312.6 ± 209.1) pmol/L vs.(3 421.6 ± 156.8) pmol/L,(4.0 ± 0.9) mmol/L vs.(3.4 ± 0.8) mmol/L,(7.4 ± 1.3)mg/L vs.(5.8 ± 1.0) mg/L,(74.3 ± 6.8) mm vs.(58.1 ± 5.5) mm,(39.6 ± 4.3) mm vs.(32.5 ± 3.8) mm],LVEF and HDL-C were lower than those in control group [(48.2 ± 3.1)％ vs.(57.3 ± 3.8)％,(0.72 ± 0.16)mmol/L vs.(1.08 ±0.27) mmol/L],and there were significant differences (P ＜0.05).There were no significant differences in the values of FPG,2 h PG and TC between two groups (P ＞ 0.05).Multivariate Logistic analysis showed that NT-proBNP and LAD were independent factors to the occurrence of auricular thrombosis (P =0.009,0.028).There was significant difference in the occurrence of auricular thrombosis between patients with NT-proBNP ＞ 4 250 pmol/L and patients with NT-proBNP≤4 250 pmol/L (P =0.028).Conclusion NT-proBNP is an independent predictor for the occurrence of auricular thrombosis to patients of CHD combined with AF.
