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| 马瑞聪（1995-），男，硕士研究生，住院医师，从事心律失常方向的研究，E-mail:fcxrcm@163.com。 |
| Risk Factors of New Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction and Analysis of Predictive Value of Serum N-Terminal pro-Brain Natriuretic Peptide and Uric Acid |
| 投稿时间：2021-09-04 修订日期：2021-09-04 |
| DOI： |
| 中文关键词: 急性心肌梗死 心房颤动 氨基末端脑钠尿肽前体 尿酸 危险因素 |
| 英文关键词: Acute myocardial infarction Atrial fibrillation N-terminal pro-brain natriuretic peptide Uric acid Risk factors |
| 基金项目:江苏省自然基金青年科技人才专项（BK201602429） |
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| 中文摘要: |
| 目的 探讨影响急性心肌梗死患者新发心房颤动的危险因素以及血清氨基末端脑钠尿肽前体（NT-proBNP）、尿酸（UA）对急性心肌梗死患者新发心房颤动的预测价值。方法 选择2019年10月至2021年5月在徐州医科大学附属医院接受诊治的急性心肌梗死患者110例，根据患者住院期间是否新发心房颤动分为房颤组（患者住院期间新发心房颤动，n=30）和无房颤组（患者住院期间未新发心房颤动，n=80）。另选择50例同期在徐州医科大学附属医院体检的健康者作为健康对照组，比较房颤组、无房颤组、健康对照组三组研究对象血清NT-proBNP、UA水平差异。收集患者各项临床资料，多因素Logistic回归分析影响急性心肌梗死患者新发心房颤动的危险因素。采用受试者工作特征（ROC）曲线分析血清NT-proBNP、UA单独以及联合检测对急性心肌梗死患者新发心房颤动的预测价值。结果 房颤组患者血清NT-proBNP、UA水平均明显高于健康对照组和无房颤组，且无房颤组高于健康对照组（P<0.05）。多因素Logistic回归分析显示，高NT-proBNP以及UA水平、高龄、左房增大、合并糖尿病、Killip心功能分级≥Ⅱ级是影响急性心肌梗死患者新发心房颤动的危险因素（P<0.05）。血清UA、NT-proBNP单独及联合预测急性心肌梗死患者新发心房颤动的曲线下面积（AUC）分别为0.730、0.737、0.840。。结论 血清NT-proBNP、UA水平对急性心肌梗死患者新发心房颤动的发生具有一定预测价值，且两者联合应用的预测价值最高，除高NT-proBNP以及UA水平外，高龄、左房增大、合并糖尿病、Killip心功能分级≥Ⅱ级亦是新发心房颤动的危险因素。 |
| 英文摘要: |
| Objective To investigate the risk factors that affect the new onset atrial fibrillation in patients with acute myocardial infarction and the predictive value of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and uric acid (UA) in patients with acute myocardial infarction. Methods A total of 110 patients with acute myocardial infarction who were diagnosed and treated in affiliated hospital of Xuzhou medical university from October 2019 to May 2021 were selected, and they were divided into atrial fibrillation group (patients with new atrial fibrillation during hospitalization, n=30 ) and the non atrial fibrillation group (the patient had no new atrial fibrillation during hospitalization, n=80) according to whether the patients had new atrial fibrillation during hospitalization. Another 50 healthy persons who underwent physical examination in affiliated hospital of Xuzhou medical university in the same period were selected as the healthy control group. The differences in serum NT-proBNP and UA levels of the three groups of subjects in the atrial fibrillation group, the non atrial fibrillation group and the healthy control group were compared. The clinical datas of the patients were collected, and multivariate Logistic regression were used to analyze the risk factors that affect the new onset atrial fibrillation in patients with acute myocardial infarction. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum NT-proBNP and UA alone and in combination for new onset atrial fibrillation in patients with acute myocardial infarction. Results The serum NT-proBNP and UA levels in patients with atrial fibrillation were significantly higher than those in healthy control group and non atrial fibrillation group, and the non atrial fibrillation group was higher than the healthy control group (P<0.05). Multivariate Logistic regression analysis showed that high NT-proBNP and UA levels, advanced age, left atrial enlargement, complicated with diabetes mellitus and Killip cardiac function grade≥grade Ⅱ were risk factors for new onset atrial fibrillation in patients with acute myocardial infarction (P<0.05). The area under the curve (AUC) of serum UA and NT proBNP in predicting new onset atrial fibrillation in patients with acute myocardial infarction were 0.730, 0.737 and 0.840 respectively. Conclusion Serum NT-proBNP and UA levels have certain diagnostic value for predicting the occurrence of new onset atrial fibrillation, and the combined use of them has the highest predictive value. Besides high NT-proBNP and UA levels, advanced age, left atrial enlargement and complicated with diabetes mellitus, Killip cardiac function grade≥grade Ⅱ are the risk factors of new onset atrial fibrillation. |
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