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目的探讨老年初发性房颤患者血浆氨基酸末端脑钠素前体(NT-proBNP)浓度与是否需要临床药物复律干预治疗的关系。方法 105名初发性房颤的老年患者,57名需要药物复律,48名自行转复为窦性心律。采用酶联免疫吸附法(ELISA)测定血浆NT-proBNP浓度。结果需要药物复律干预治疗的患者就诊时血浆NT-proBNP浓度高于自我复律组(508.7±45.7fmol/L vs 449.8±48.7fmol/L,P=0.0001)。血浆NT-proBNP浓度与患者是否存在高血压病、冠心病和房颤发病时间呈正相关。单元Logistic分析显示:房颤发作的时间(P=0.037)和血浆NT-proBNP浓度(P=0.0003)与初发性房颤发作时需要药物复律有关。多元Logistic分析显示:血浆NT-proBNP浓度(P<0.001)能预测初发性房颤发作时是否需要药物复律。结论老年初发性房颤患者就诊时血浆NT-proBNP浓度升高,且能预测是否需要药物复律。急诊测定血浆NT-proBNP浓度有助于指导房颤发作时的药物干预治疗。
Objective To investigate the relationship between plasma concentration of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and the need for clinical medication of cardioversion in elderly patients with primary AF. Methods A total of 105 elderly patients with essential AF were enrolled, 57 required cardioversion and 48 were converted to sinus rhythm. Plasma NT-proBNP concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results The plasma concentration of NT-proBNP at the time of visit was higher in patients requiring drug cardioversion than in the self-regroup (508.7 ± 45.7 fmol / L vs 449.8 ± 48.7 fmol / L, P = 0.0001). Plasma NT-proBNP concentration and whether patients with hypertension, coronary heart disease and atrial fibrillation onset time was positively correlated. Logistic analysis showed that the onset of atrial fibrillation (P = 0.037) and plasma NT-proBNP concentration (P = 0.0003) were related to the need for drug cardioversion during the onset of AF. Multivariate Logistic analysis showed that the plasma concentration of NT-proBNP (P <0.001) predicted the need for drug cardioversion in patients with primary AF. Conclusion The plasma concentration of NT-proBNP at the onset of AF in elderly patients with primary AF may predict the need for drug cardioversion. Emergency determination of plasma NT-proBNP concentration helps to guide pharmacological interventions in the onset of atrial fibrillation.