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目的:通过对心房颤动(房颤)患者复律后心房超声检查及血浆脑利钠肽(BNP)的检测,探讨心房顿抑与BNP的关系。方法:将76例房颤患者分为阵发性房颤组(40例)和持续性房颤组(36例),另入选对照组患者20例。在房颤复律后2h、1d、1周和1个月时经胸壁超声心动图(TTE)检查测定舒张晚期血流速度(A峰)和心房充盈分数(AFF),以A峰<50cm/s作为心房顿抑的标准,并测定上述时间点及复律前血浆BNP。结果:阵发性房颤组复律后2h心房顿抑的发生率为45.0%,复律后A峰和AFF至1周时恢复正常;持续性房颤组复律后2h左房顿抑的发生率为61.6%,A峰和AFF至1个月时恢复正常。2组复律后1d和1周时BNP与A峰有显著的相关性,在房颤复律后1d和1周时仍然存在心房顿抑的患者BNP显著高于无顿抑发生的患者(P<0.01),心房顿抑消失后,BNP迅速下降。结论:房颤复律后1d和1周时血浆BNP水平与跨二尖瓣A峰有相关性,较高的血浆BNP可能提示心房顿抑的持续存在,有助于了解左心房功能恢复情况。
OBJECTIVE: To investigate the relationship between atrial fibrillation (BN) and BNP through atrial fibrillation (AF) after cardioversion and atrial natriuretic peptide (BNP) after cardioversion. Methods: A total of 76 patients with atrial fibrillation were divided into paroxysmal atrial fibrillation group (40 cases) and persistent atrial fibrillation group (36 cases), and another 20 cases were selected as control group. Late diastolic flow velocity (A peak) and atrial filling fraction (AFF) were determined by chest wall echocardiography (TTE) at 2h, 1d, 1 week and 1 month after cardioversion. s as a standard of stunned atrial fibrillation, and determine the time point and pre-cardioversion plasma BNP. Results: The incidence of atrial fibrillation at 2h after cardioversion in patients with paroxysmal atrial fibrillation was 45.0%, and peaked at A peak and AFF to 1 week after cardioversion. Left atrial fibrillation The incidence of 61.6%, A peak and AFF returned to normal after 1 month. There was a significant correlation between BNP and peak A at 1 and 1 week after cardioversion in two groups. BNP was still significantly higher in patients with atrial fibrillation at 1 and 1 week after cardioversion (P <0.01). After atrial stunning disappeared, BNP decreased rapidly. CONCLUSION: Plasma BNP levels correlate with cross-peak A peak at 1 and 1 week after cardioversion. Higher plasma BNP levels may indicate the persistence of atrial fibrillation and help to understand the recovery of left atrial function.