N-末端脑钠肽前体对冠状动脉旁路移植术术后房颤的预测价值

doi:10.3969/j.issn.1006-6233.2017.08.022

摘要
图/表
参考文献
相关文章 (3)

全文: PDF (1408 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨N-末端脑钠肽前体对冠状动脉旁路移植术术后房颤的预测价值。方法: 收集来我院住院行冠状动脉旁路移植术患者132例的临床资料,均为2011年9月至2015年1月的病例,观察的结局事件是术后房颤事件,分为房颤组39例和窦律组93例,收集所有患者的基本资料,包括年龄、性别、BMI、EuroScore、NYHA分级、基础疾病(高血压、糖尿病)、口服药物(β受体拮抗剂、钙离子通道阻滞剂、他汀类药物)、重症监护时间、呼吸机使用时间等,记录心脏彩超(LAD、LVESD、IVST、LVEDD、LVEF)和生化检查(NT-proBNP、hs-CRP、ALT、AST、Cr、RDW、RBC),以术后房颤为因变量,以单因素分析有差异的指标为自变量,行Logistic多因素回归分析。结果: 术后房颤发生率为29.55%(39/132),CCABG组房颤发生率(46.94%)高于OPCAB组(19.28%),差异有统计学意义(P<0.05);房颤组和窦律组在平均年龄、EuroScore、NYHA分级、重症监护时间、呼吸机使用时间、β受体拮抗剂上,差异有统计学意义(P<0.05);房颤组和窦律组在术后24h LAD、术后24h LVEF上,差异有统计学意义(P<0.05);房颤组和窦律组在NT-proBNP、术后24h hs-CRP、术后24h RDW上,有差异(P<0.05);年龄、术后24h LAD、NT-proBNP为冠状动脉旁路移植术术后房颤发生的独立预测因素(P<0.05)。结论: 年龄、术后24h LAD、NT-proBNP为冠状动脉旁路移植术术后房颤发生的独立预测因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ： N-末端脑钠肽前体, 冠状动脉旁路移植术, 术后房颤, 诊断价值

Abstract：Objective: To investigate the diagnostic value of N- terminal brain natriuretic peptide (BNP) in patients with atrial fibrillation after coronary artery bypass grafting (CABG). Methods: 132 cases in our hospital underwent coronary artery bypass grafting were selected in September 2011 to January 2015 were the observation of outcomes were atrial fibrillation events after operation, 39 cases divided into AF group and 93 cases into sinus rhythm group, the basic data of all patients were collected, including age BMI, EuroScore, NYHA, gender, grade, basic diseases (hypertension, diabetes), oral drugs (beta blockers, calcium channel blockers, statins), intensive care time, ventilator time, record cardiac ultrasound (LAD, LVESD, IVST, LVEDD, LVEF (NT-proBNP) and biochemical examination ALT, AST, hs-CRP, Cr, RBC, RDW), the dependent variable of postoperative atrial fibrillation, using single factor analysis of the difference between indicators as independent variables, multivariate regression analysis for Logistic. Results: The incidence of postoperative atrial fibrillation was 29.55% (39/132), the incidence of atrial fibrillation in CCABG group (46.94%) was higher than that of OPCAB group (19.28%), there are differences (P<0.05). AF group and sinus rhythm group in average age, EuroScore, NYHA grade, intensive care time, ventilator time, beta receptor antagonist, difference (P<0.05). AF group and sinus rhythm group in postoperative 24h LAD, after 24h LVEF, there are differences (P<0.05). AF group and sinus rhythm group at NT-proBNP, 24h after surgery and postoperative 24h hs-CRP RDW, there are differences (P<0.05). age, postoperative 24h LAD, NT-proBNP after surgery as an independent predictor of coronary artery bypass grafting with atrial fibrillation (P<0.05). Conclusion: Age, postoperative 24h, LAD, and NT-proBNP were independent predictors of atrial fibrillation after coronary artery bypass grafting.

Key words： N-terminal pro brain natriuretic peptide Coronary artery bypass grafting Postoperative atrial fibrillation Diagnostic value

基金资助:山东省卫生厅科研计划项目,(编号:2013WS2761)

引用本文:

王兆东, 周保国, 马骏, 梁雁翎, 魏勇, 迟增鑫, 胡瑞成, 张振宇. N-末端脑钠肽前体对冠状动脉旁路移植术术后房颤的预测价值[J]. 河北医学, 2017, 23(8): 1310-1315.
WANG Zhaodong. Predictive Value of N-terminal Brain Natriuretic Peptide Precursor for Atrial Fibrillation after Coronary Artery Bypass Grafting. 河北医学, 2017, 23(8): 1310-1315.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.08.022 或 http://www.hbyxzzs.cn/CN/Y2017/V23/I8/1310

[1] Ji T, Feng C, Sun L, et al. Are beta-blockers effective for preventing post-coronary artery bypass grafting atrial fibrillation direct and network meta-analyses[J].Irish Journal of Medical Science,2016,185(2):503~511.
[2] Hammond D A, Smotherman C, Jankowski C A, et al. Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries[J].Clinical Research in Cardiology, 2015,104(5):410~417.
[3] Zhao L P, Kofidis T, Lim T W, et al. Sleep apnea is associated with new-onset atrial fibrillation after coronary artery bypass grafting[J].Journal of Critical Care,2015,30(6):1418.e1~1418.e5.
[4] 韩宏光,王辉山,孟庆涛,等.非体外循环冠状动脉旁路移植术后心房颤动危险因素分析[J].临床误诊误治,2016,29(7):58~63.
[5] Romero I, Nedios S, Kriatselis C. Diagnosis and management of atrial fibrillation: an overview[J].Cardiovascular Therapeutics,2014,32(5):242~252.
[6] Aldea G S, Bakaeen F, Pal J, et al. The society of thoracic surgeons clinical practice guidelines on arterial conduits for coronary artery bypass grafting[J].Annals of Thoracic Surgery,2015,101(2):801.
[7] 中国医师协会心律学专业委员会心房颤动防治专家工作委.心房颤动:目前的认识和治疗建议[J].中华心律失常学杂志,2015,19(5):321~384.
[8] 陆杰,李东玉,徐世安.冠状动脉旁路移植术后新发心房颤动的多因素分析[J].中国医科大学学报,2016,45(3):273~277.
[9] 浦伟青,秦娜梅,王志农.冠状动脉旁路移植术后早发房颤患者疾病不确定感的相关因素研究[J].中国医药导报,2016,13(5):67~70.
[10] 侯鹏,王辉山.冠状动脉旁路移植术后新发心房颤动术前预测因素研究进展[J].中国胸心血管外科临床杂志,2015(4):366~370.
[11] 路亚枫,齐弘炜,吴明营,等.脑钠肽和高敏C反应蛋白对冠脉旁路移植术后早期并发症的预测价值[J].北京医学,2015(2):107~111.
[12] 任明明,韩振,欧阳淑园,等.多指标评估体外循环与非体外循环冠状动脉旁路移植术心肌损伤的研究[J].重庆医学,2015,44(33):4641~4643.
[13] 谭今,黄克力,于涛,等.不同循环模式对冠状动脉旁路移植术后认知功能的远期影响[J].临床军医杂志,2016,43(12):30~33.
[14] Vlahou A, Diplaris K, Ampatzidou F, et al.The role of blood transfusion in the development of atrial fibrillation after coronary artery bypass grafting[J].Thoracic & Cardiovascular Surgeon,2016,64(08):688~692.
[15] Mukaida M, Okabayashi H. Anticoagulant and antiplatelet therapy in patients with atrial fibrillation undergoing coronary artery bypass grafting[J].2015,21(3):258~262.
[16] 周自强,吴明营,杨青苗,等.左心房容积与冠状动脉旁路移植术后心房颤动相关性的研究[J].心肺血管病杂志,2015,34(2):106~109.
[17] 韩宏光,王辉山,金岩,等.心脏结构及功能对非体外循环冠状动脉旁路移植术后心房颤动的影响[J].广西医学,2016,38(6):809~813.
[18] 权晓强,程兆云,赵健,等.老年冠心病患者非体外循环冠状动脉旁路移植术后心房颤动的危险因素分析[J].中华老年医学杂志,2015,34(3):231~233.
[19] 孙晓峰,李野,赵玉石,等.N末端脑钠肽前体在围冠状动脉搭桥术期的变化及意义[J].现代生物医学进展,2014,14(5):993~996.
[20] 李晓密,韩宏光,王辉山,等.红细胞分布宽度与N末端脑利钠肽前体对OPCAB术后患者阵发性心房颤动的预测价值[J].中国心血管病研究,2016,14(9):812~818.