NT-proBNP、hs-CRP、LAD与慢性心力衰竭合并心房颤动的相关性

doi:10.3969/j.issn.1004-583X.2021.05.005

摘要/Abstract

摘要：

目的分析N末端B型利钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)、左心房内径(LAD)与慢性心力衰竭(CHF)合并心房颤动的相关性。方法选取2019年9月-2020年9月在我院治疗的CHF患者287例,其中合并心房颤动患者91例为观察组,未合并心房颤动患者196例为对照组,分析两组一般资料、血糖、血脂、尿酸、肌酐、NT-proBNP、hs-CRP及超声心动图指标的差异,采用Logistic回归分析导致CHF患者发生心房颤动的危险因素。结果观察组病程、NYHA分级为IV级患者比例、尿酸、肌酐、NT-proBNP、hs-CRP、LAD高于对照组(P<0.01)。Logistic分析显示,病程(OR=1.638)、心功能分级(OR=2.242)、NT-proBNP(OR=2.863)、hs-CRP(OR=2.341)、LAD(OR=3.671)是导致CHF合并心房颤动的主要影响因素(P<0.05)。结论病程长、NYHA分级为IV级、NT-proBNP以及hs-CRP水平升高、LAD增大的CHF患者合并心房颤动的风险升高,对于存在上述危险因素的CHF患者应加强针对性干预,以减少心房颤动的发病。

关键词: 心力衰竭, 炎症因子, 心房颤动, 左心房内径, 心功能

Abstract:

Objective To analyze the correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), left atrium diameter (LAD) and chronic heart failure (CHF) concurrent with atrial fibrillation. Methods A total of 287 CHF patients treated in our hospital from September 2019 to September 2020 were selected, 91 patients with atrial fibrillation were divided into the observation group and 196 patients without atrial fibrillation into in the control group. The difference of general information, blood glucose, blood lipid, uric acid, creatinine, NT-proBNP, hs-CRP and echocardiogram indexes in the two groups were analyzed, and the risk factors of CHF concurrent with atrial fibrillation were analyzed by Logistic regression. Results The course of disease, proportion of patients with New York Heart Association(NYHA) grade IV, uric acid, creatinine, NT-proBNP, hs-CRP, as well as LAD in the observation group were higher than in the control group(P<0.01). Logistic regression analysis showed that the course of disease (OR=1.638), cardiac function class (OR=2.242), NT-proBNP (OR=2.863), hs-CRP (OR=2.341), LAD(OR=3.671) were the main influencing factors of CHF concurrent with atrial fibrillation (P<0.05). Conclusion Long course of disease, IV in NYHA grade, the levels of NT-proBNP, hs-CRP and LAD increase added the risk of CHF concurrent with atrial fibrillation of patients. For CHF patients, targeted intervention should be strengthened to reduce the incidence of atrial fibrillation.

Key words: heart failure, inflammatory factors, atrial fibrillation, left atrium diameter, heart function

中图分类号:

赵美丽, 肖立远, 刘林, 康超, 张秋香. NT-proBNP、hs-CRP、LAD与慢性心力衰竭合并心房颤动的相关性[J]. 临床荟萃, 2021, 36(5): 412-415.

Zhao Meili, Xiao Liyuan, Liu Lin, Kang Chao, Zhang Qiuxiang. Correlation between NT-proBNP, hs-CRP, left atrium diameter and chronic heart failure concurrent with atrial fibrillation[J]. Clinical Focus, 2021, 36(5): 412-415.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.05.005

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I5/412

图/表 5

参考文献 20

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组别		例数		性别[例(%)]				年龄 (岁)		BMI (kg/m²)		病程 (月)
组别		例数		男		女		年龄 (岁)		BMI (kg/m²)		病程 (月)
观察组		91		55(60.44)		36(39.56)		58.27±7.92		23.77±3.25		31.45±9.72
对照组		196		118(60.20)		78(39.80)		56.82±6.75		23.95±3.12		23.14±10.37
χ²/t值				0.001				1.601		0.449		6.442
P值				0.970				0.111		0.654		<0.01
组别	例数		NYHA心功能分级[例(%)]					合并症[例(%)]			饮酒史 [例(%)]		吸烟史 [例(%)]
组别	例数		Ⅱ级		Ⅲ级		Ⅳ级	糖尿病	高血压		饮酒史 [例(%)]		吸烟史 [例(%)]
观察组	91		8(8.79)		57(62.64)		26(28.57)	37(40.66)	34(37.36)		17(18.68)		41(45.05)
对照组	196		31(15.82)		136(69.39)		29(14.80)	78(39.80)	77(39.29)		38(19.39)		79(40.31)
χ²/t值			2.612		1.286		7.613	0.019	0.097		0.020		0.576
P值			0.106		0.257		0.006	0.890	0.756		0.887		0.448

组别		例数		性别[例(%)]				年龄 (岁)		BMI (kg/m²)		病程 (月)
组别		例数		男		女		年龄 (岁)		BMI (kg/m²)		病程 (月)
观察组		91		55(60.44)		36(39.56)		58.27±7.92		23.77±3.25		31.45±9.72
对照组		196		118(60.20)		78(39.80)		56.82±6.75		23.95±3.12		23.14±10.37
χ²/t值				0.001				1.601		0.449		6.442
P值				0.970				0.111		0.654		<0.01
组别	例数		NYHA心功能分级[例(%)]					合并症[例(%)]			饮酒史 [例(%)]		吸烟史 [例(%)]
组别	例数		Ⅱ级		Ⅲ级		Ⅳ级	糖尿病	高血压		饮酒史 [例(%)]		吸烟史 [例(%)]
观察组	91		8(8.79)		57(62.64)		26(28.57)	37(40.66)	34(37.36)		17(18.68)		41(45.05)
对照组	196		31(15.82)		136(69.39)		29(14.80)	78(39.80)	77(39.29)		38(19.39)		79(40.31)
χ²/t值			2.612		1.286		7.613	0.019	0.097		0.020		0.576
P值			0.106		0.257		0.006	0.890	0.756		0.887		0.448

组别	例数	FBG (mmol/L)	TC (mmol/L)	TG (mmol/L)	HDL-C (mmol/L)	LDL-C (mmol/L)	UA (μmol/L)	Cr (μmol/L)
观察组	91	6.73±1.13	4.67±1.16	1.78±0.89	1.12±0.59	3.41±0.52	435.82±86.28	123.84±29.45
对照组	196	6.54±1.05	4.59±0.97	1.94±0.84	1.14±0.46	3.34±0.48	391.47±91.53	112.43±25.73
t值		1.392	0.610	1.473	0.312	1.119	3.889	3.336
P值		0.165	0.542	0.142	0.755	0.264	<0.01	0.001

组别	例数	FBG (mmol/L)	TC (mmol/L)	TG (mmol/L)	HDL-C (mmol/L)	LDL-C (mmol/L)	UA (μmol/L)	Cr (μmol/L)
观察组	91	6.73±1.13	4.67±1.16	1.78±0.89	1.12±0.59	3.41±0.52	435.82±86.28	123.84±29.45
对照组	196	6.54±1.05	4.59±0.97	1.94±0.84	1.14±0.46	3.34±0.48	391.47±91.53	112.43±25.73
t值		1.392	0.610	1.473	0.312	1.119	3.889	3.336
P值		0.165	0.542	0.142	0.755	0.264	<0.01	0.001

组别	例数	NT-proBNP(ng/L)	hs-CRP(mg/L)
观察组	91	258.27±13.64	31.48±3.58
对照组	196	179.34±12.36	19.74±3.22
t值		48.695	27.727
P值		<0.01	<0.01