血浆氨基末端脑利钠前体水平对心力衰竭合并心房纤颤患者的近期预后价值.pdfVIP

． 24 Decem ber 2007 · 41· Journal of Medical Forum Vo1．28 No — — ． ． ． ． ． ． ． ． ． ． ． ． ． ． ． ． ． ． ． ．．．．， ． ． ． ． ． ． ． ． ． ． ． ． ． ． — — 血浆氨基末端脑利钠前体水平对心力衰竭 合并心房纤颤患者的近期预后价值 朱明辉，黎志明，韩国华 张家港市第一人民医院心内科 张家港市 215600 摘要 目的 探讨血浆氨基末端脑利钠前体(NT—proBNP)水平对合并心房纤颤(atrial fibrillation，AF)的 心力衰竭患者的近期预后价值。方法 选择82例心力衰竭患者为研究对象，其中31例合并AF。测定患者血 浆NT—proBNP水平，并对存活的患者出院后随访30天，终点事件为失代偿再入院或死亡。结果 共有16例患 者发生了终点事件，其中10例为AF患者。发生终点事件的AF患者的血浆NT—proBNP水平中位数显著高于 未发生终点事件的AF患者(P0．05)。Cox比例风险模型分析显示，NT—proBNP水平是预测合并AF心力衰 竭患者是否发生终点事件的独立预测因子(R R=29．61，95％CI1．29～680．4，P=0．034)。结论 血浆NT— proBNP水平是预测心力衰竭合并房颤患者近期是否发生死亡或因代偿心衰再住院的有价值的生化指标。 关键词 钠尿肽，脑；心房纤颤；心力衰竭；预后 中图分类号：R541．6 文献标识码：A 文章编号：1672—3422(2007)24-0041—03 Prognostic Value of Plasma N —termina Pro—brain Natriuretic Peptide Level in Heart Failure Patients with Atrial Fibrillation ZHU Minghui，LI Zhiming，HAN Guohua Department of Cardiology，The First Peoples Hospital of Zhangjiagang，Zhangjiagang 2 1 5600，China ABSTRACT 0bjective To evaluate the value of plasma NT—proBNP in predicting short— term outcome in heart failure patients with ltl’ial fibrillation(AF)．Methods Total 82 heart failure pa— tients including 3 1 AF were analyzed．Pati 1．tS discharged alive were followed for 30 days．The primary endpoint was death or readmission due to decompensated heart failure．Results The primary endpoint was observed in 16 patients including 10AF．Among AF with primary endpoint，the median NT—proB— NP level was significantly higher compared with AF without primary endpoint(P0．05)．In Cox multivariate proportional——hazards regression models the LogNT——proBNP was the strongest in