摘要目的 观察阵发性心房颤动和心房扑动患者血清脑钠肽(BNP)水平,并探讨其临床意义.方法 选择非瓣膜性心脏病阵发性心房扑动患者126例(心房扑动组)、阵发性心房颤动患者96例(心房颤动组)及对照组72例作为研究对象.其中心房扑动组中,24 h内转复42例(A组),24～48h转复51例(B组),48h内未转复33例(C组).采用酶联免疫吸附法测定各组血清BNP水平,应用超声心动图测定各组左房内径(LAD)和左室射血分数(LVEF)并进行比较.结果 A、B、c组和心房颤动组BNP水平分别为(764.9±123.3)、(857.8±106.2)、(975.3±99.5)、(1137.2±113.2)ng/L,明显高于对照组的(251.3±42.5)ng/L,差异有统计学意义(P<0.05),而A、B、C组中BNP水平依次升高,两两比较差异有统计学意义(P<0.05);心房颤动组BNP水平明显高于A、B、C组(P<0.05).A、B、C组和心房颤动组LAD分别为(4.11±0.49)、(3.97±0.50)、(4.19±0.76)、(4.08±0.51)cm,明显高于对照组的(3.22±0.87)cm,差异有统计学意义(P<0.05),而A、B、C组与心房颤动组LAD比较差异无统计学意义(P>0.05).各组间LVEF比较差异无统计学意义(P>0.05).结论 阵发性心房颤动与心房扑动都是促进BNP分泌的重要因素,BNP对预测阵发性心房扑动的转复效果具有重要的临床意义.

abstractsObjective To observe the changes of serum brain natriuretic peptide(BNP)and its clinical significance in patients with paroxysmal atrial fibrillation and atrial flutter.Methods All the patients with nonvalvular heart diseases were divided into 3 groups:control group(72 patients),atrial flutter group(126 patients),and atrial fibrillation group(96 patients).Meanwhile the patients in atrial flutter group were divided into 3 groups: the patients achieving cardioversion in 24 hours(group A),the patients achieving cardioversion in 24-48 hours(group B)and the patients losing cardioversion in 48 hours(group C).The serum levels of BNP were measured by ELISA method after admission,and the left atrium diameter(LAD)and left ventricular ejection fraction(LVEF)were described by ultrasound.Results The serum level of BNP in atrial flutter group(group A,B,C)and atrial fibrillation group was higher than that in control group[(764.9 ± 123.3),(857.8±106.2),(975.3±99.5),(1137.2 ± 113.2)ng/L vs(251.3 ± 42.5)ng/L,P <0.05].Among the A,B,C groups,the serum level of BNP increased in order,and showed statistical differences(P < 0.05).The serum level of BNP in atrial fibrillation group was higher than that in group A,B,C(P < 0.05).The LAD in group A,B,C and atrial fibrillation group[(4.11 ± 0.49),(3.97 ± 0.50),(4.19 ±0.76),(4.08±0.51)cm]was higher than that in control group[(3.22 ± 0.87)cm](P < 0.05),but there was no statistical differences between group A,B,C and atrial fibrillation group(P > 0.05).The level of LVEF had no statistical differences among the groups.Conclusion Paroxysmal atrial fibrillation and atrial flutter have enhanced effect on the secretion of BNP,which plays an important role in predicting the results of drug conversion.