CAJ | 학술논문

目的：探究慢性或持续性心房颤动（房颤）并发心力衰竭（心衰）或伴有心衰前期症状患者血清C反应蛋白（CRP）、纤维蛋白原（Fib）、氨基末端脑钠肽前体（NT－proBNP）特点。方法回顾性分析2009年1月至2013年6月十堰市中医医院住院治疗的78例房颤或者房颤并发其他并发症患者，其中房颤并发重度心衰21例（ A 组）；持续性或持久性房颤伴明显心衰前期症状患者34例（ B组）；阵发性房颤患者23例（ C组）。同时选取对照组健康正常人群30例（ D组）。 A、B、C组患者入院时抽血，D组抽血时间不定，检测血清CRP、Fib、NT－proBNP水平。结果 A、B、C和D四组CRP水平分别为（120．3±22．7）、（50．3±15．7）、（4．1±1．3）mg／L和（3．7±1．2）mg／L，4组间差异有统计学意义（P＜0．01）；4组Fib分别（287．2±38．3）、（41．2±11．6）、（4．5±0．8） mg／L和（2．7±0．3） mg／L，其中A组Fib水平显著高于 B、C、D 组，差异有统计学意义（ P ＜0．05）；NT－proBNP分别为（1092．8±218．3）、（692．4±101．5）、（395．3±51．8） ng／L 和（172．4±32．0） ng／L，差异有统计学意义（P ＜0．01）。 CRP、Fib和NT－proBNP在房颤伴有心衰患者血清中升高呈正相关（P＜0．05），但是在C组仅CRP与T－proBNP呈正相关（P＜0．05）。结论 CRP、Fib和 NT－proBNP在房颤并发早期心衰患者血清中水平升高，明显高于正常健康人群血清水平，联合诊断可以提高房颤并发早期心衰诊断敏感性，使得临床及早干预。
목적：탐구만성혹지속성심방전동（방전）병발심력쇠갈（심쇠）혹반유심쇠전기증상환자혈청C반응단백（CRP）、섬유단백원（Fib）、안기말단뇌납태전체（NT－proBNP）특점。방법회고성분석2009년1월지2013년6월십언시중의의원주원치료적78례방전혹자방전병발기타병발증환자，기중방전병발중도심쇠21례（ A 조）；지속성혹지구성방전반명현심쇠전기증상환자34례（ B조）；진발성방전환자23례（ C조）。동시선취대조조건강정상인군30례（ D조）。 A、B、C조환자입원시추혈，D조추혈시간불정，검측혈청CRP、Fib、NT－proBNP수평。결과 A、B、C화D사조CRP수평분별위（120．3±22．7）、（50．3±15．7）、（4．1±1．3）mg／L화（3．7±1．2）mg／L，4조간차이유통계학의의（P＜0．01）；4조Fib분별（287．2±38．3）、（41．2±11．6）、（4．5±0．8） mg／L화（2．7±0．3） mg／L，기중A조Fib수평현저고우 B、C、D 조，차이유통계학의의（ P ＜0．05）；NT－proBNP분별위（1092．8±218．3）、（692．4±101．5）、（395．3±51．8） ng／L 화（172．4±32．0） ng／L，차이유통계학의의（P ＜0．01）。 CRP、Fib화NT－proBNP재방전반유심쇠환자혈청중승고정정상관（P＜0．05），단시재C조부CRP여T－proBNP정정상관（P＜0．05）。결론 CRP、Fib화 NT－proBNP재방전병발조기심쇠환자혈청중수평승고，명현고우정상건강인군혈청수평，연합진단가이제고방전병발조기심쇠진단민감성，사득림상급조간예。
Objective To research the characteristics of C-reactive protein(CRP),fibrinogen(Fib), and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with chronic or persistent atrial fibril-lation possibly complicated with heart failure or early symptoms of heart failure .Methods From Jan.2009 to Jun.2013,a retrospective analysis on 78 patients with atrial fibrillation or atrial fibrillation complicated with other complications in Department of Cardiology of Shiyan Traditional Chinese Medicine Hospital was done , including 21 patients with atrial fibrillation complicated with severe heart failureas group A;34 patients with persistent atrial fibrillation with heart failure with obvious early symptoms as group B;23 patients with parox-ysmal atrial fibrillation as group C.30 normal healthy people were selected as controls(group D).The serum levels of CRP,Fib,NT-proBNP of group A,B,C,D were detected.Results The level of CRP in group A, B,C and D was (120.3 ±22.7),(50.3 ±15.7),(15.7 ±1.3) and (3.7 ±1.2) mg/L and the difference was statistically significant (P<0.01).Fib in four groups were (287.2 ±38.3),(41.2 ±11.6),(287.2 ± 0.8) and (2.7 ±0.3) mg/L,and the difference was statistically significant(P<0.05).The Fib in group A was the highest among the four groups.NT-proBNP were (1092.8 ±218.3),(692.4 ±101.5),(395.3 ± 51.8) and (172.4 ±32.0) ng/L,and the difference was statistically significant(P<0.01).There was pos-itive correlation between CRP/Fib and NT-proBNP in group B ( P <0.05 ) , but in group C only CRP and T-pro BNP had positive correlation (P<0.05).Conclusion CRP,Fib and NT-pro BNP levels in serum in patients with atrial fibrillation complicated by heart failure are significantly higher than that of normal healthy population,and joint diagnosis can improve the diagnostic sensitivity of concurrent heart failure and make early clinical intervention.