CAJ | 학술논문

目的探讨房颤对血脑利钠肽(BNP)水平的影响及房颤复发的相关因素.方法选择阵发性或持续性房颤非心衰患者49例(房颤组),另择同期类似疾病窦性心律患者50例作为对照组.检测对照组及房颤组复律前的血BNP水平.房颤组患者使用胺碘酮药物复律,在复律后24h检测血BNP水平,并随访观察6个月.比较分析6个月内房颤组复发与未复发患者的血BNP水平及临床特征.结果复律前房颤组血BNP水平显著高于对照组(P<0.01);房颤组复律后血BNP水平显著低于复律前(P<0.01),与对照组比较差异无统计学意义(P>0.05).随访期间房颤组31例未复发,18例复发;复律前后复发者血BNP水平均显著高于未复发者(均P<0.01);复发者与未复发者仅左房内径、病程、束支传导阻滞、二尖瓣反流等临床特征的差异具有统计学意义(P<0.05或0.01).结论房颤患者血BNP水平升高,并在复律时降低.血BNP水平、左房内径、房颤病程、束支传导阻滞、二尖瓣反流等特征可能与房颤复发有关.
목적탐토방전대혈뇌리납태(BNP)수평적영향급방전복발적상관인소.방법선택진발성혹지속성방전비심쇠환자49례(방전조),령택동기유사질병두성심률환자50례작위대조조.검측대조조급방전조복률전적혈BNP수평.방전조환자사용알전동약물복률,재복률후24h검측혈BNP수평,병수방관찰6개월.비교분석6개월내방전조복발여미복발환자적혈BNP수평급림상특정.결과복률전방전조혈BNP수평현저고우대조조(P<0.01);방전조복률후혈BNP수평현저저우복률전(P<0.01),여대조조비교차이무통계학의의(P>0.05).수방기간방전조31례미복발,18례복발;복률전후복발자혈BNP수평균현저고우미복발자(균P<0.01);복발자여미복발자부좌방내경、병정、속지전도조체、이첨판반류등림상특정적차이구유통계학의의(P<0.05혹0.01).결론방전환자혈BNP수평승고,병재복률시강저.혈BNP수평、좌방내경、방전병정、속지전도조체、이첨판반류등특정가능여방전복발유관.
Objective To investigate the association of blood brain natriuretic peptide(BNP) levels with atrial fibrillation (AF) and other related factors for AF recurrence. Methods Forty nine consecutive patients referred for cardioversion of persistent or paroxysmal AF were enrolled in the study, another 50 patients of similar diseases with sinus rhythm served as control group. Blood samples were obtained for measuring BNP levels in both AF and control groups. Al the AF patients received oral amio-darone to restore sinus rhythm and BNP levels were measured again 24h after restoration. Patients were then fol owed for 6 months to assess the recurrence of AF and the BNP levels and clinic features were compared between recurrent and non-recur-rent patients. Results BNP levels in AF group were significantly higher than those in control group before cardioversion (P<0.01). BNP levels in AF group before cardioversion were significantly higher than those after cardioversion (P<0.01), but there were no significant difference compared to control group (P>0.05). Among 49 patients 31 maintained sinus rhythm but 18 pre-sented a recurrence of AF in 6 months after cardioversion. BNP levels in non-recurrence group were significantly lower than those in recurrence group either before or after cardioversion (P<0.01). Characteristics such as left atrial diameter, course of AF, bundle branch block, mitral regurgitation were statistical y different between non-recurrence and recurrence group of AF patients (P<0.05 or 0.01). Conclusion BNP levels are elevated in AF patients and decreased after cardioversion. BNP levels, left atrial diam-eter, course of AF, bundle branch block, mitral regurgitation in AF patients may be correlated with AF recurrence.