| 朱小慧,王长远,吉训明,王 晶,曹 涛,邢绣荣.NT-proBNP对胺碘酮用于急诊阵发房颤复律疗效的预测价值[J].,2019,19(14):2675-2678 |
| NT-proBNP对胺碘酮用于急诊阵发房颤复律疗效的预测价值 |
| Porgnostic Prediction Value of NT-proBNP for the Cardioversion of Recent-onset Atrial Fibrillation by Amiodarone in the Emergency Department |
| 投稿时间：2019-02-07 修订日期：2019-02-28 |
| DOI：10.13241/j.cnki.pmb.2019.14.014 |
| 中文关键词: 房颤 复律 胺碘酮 NT-proBNP |
| 英文关键词: Atrial fibrillation Cardioversion Amiodarone nt-proBNP |
| 基金项目:北京市扬帆计划重点医学专业基金项目(ZYLX01706) |
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| 中文摘要: |
| 摘要 目的：研究N末端B型利钠肽原(N-terminal pro B-type natriuretic peptide, NT-proBNP)对胺碘酮用于急诊阵发性非瓣膜病心房颤动疗效的预测价值。方法：收集2016-2017年于宣武医院急诊科诊断为阵发性非瓣膜病房颤(发病48h内)的患者共110例，记录所有患者人院时一般资料、既往病史、临床症状体征、实验室数据及测定肌钙蛋白I(Troponin-I, TnI)水平和基线NT-proBNP水平，均给予胺碘酮静脉转复治疗。按照胺碘酮转复情况分为成功组和失败组。结果：静脉应用胺碘酮成功转复91例(82.7％)，平均转复时间8.15小时(SD10.16)，转复失败者24 h内心室率均控制在100次/min以下，均无严重不良反应。成功组血浆基线NT-proBNP水平显著低于失败组(P<0.05)；而两组患者性别、年龄、入室血压、心室率、胸痛、房颤持续时间、入室心电图ST段压低、TnI水平、冠心病史、高血压、糖尿病、房颤史比较差异均无统计学意义(P>0.05)。二元logistic回归分析显示NT-proBNP 的自然对数，即In(NT-proBNP)为急诊房颤胺碘酮复律疗效的主要影响因素。结论：对于非瓣膜病房颤急性发作<48 h的患者，胺碘酮转复是安全有效的；基线NT-proBNP水平是药物复律成功的重要预测因子，如基线NT-proBNP水平较高，则复律成功率低，为了避免药物的不良反应，可考虑控制心室率，而不是复律治疗。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the role of N-terminal pro B-type natriuretic peptide (NT-proBNP) in predicting the success of cardioversion of recent-onset atrial fibrillation by Amiodarone in the emergency department. Methods: A total of 110 patients with non-valvular atrial fibrillation (within 48 hours) were enrolled in the emergency department of Xuanwu Hospital from 2016 to 2017. A general information, past medical history, clinical symptoms and signs, and laboratory data of Troponin-I(TnI) and baseline NT-proBNP were all recorded. All the patients were treated with intravenous amiodarone. 110 patients were divided into two groups according to cardioversion results: successful group and unsuccessful group. Results: Successful conversion rates were 91(81.67%). The average time was 8.15 hours (SD10.16h), and the ventricular rates were controlled below 100 /min within 24 hours in the unsuccessful group. No serious adverse events were found. Baseline NT-proBNP levels were significantly lower in the successful group than in the unsuccessful group(P<0.05); There were no significant differences between the two groups in gender, age, systolic pressure(SYS), ventricular rate, chest pain, duration of atrial fibrillation(AF), ST-segment depression on the initial ECG, TnI levels, the history of coronary artery disease(CAD), hypertension(HTN), diabetes(DM), chronic lung disease and atrial fibrillation (P>0.05). According to binary logistic regression analysis, in (Nt-proBNP) was the main predictor for the successof cardioversion using amiodarone. Conclusion: Chemical cardioversion using amiodarone is safe and effective in patients with acute non-valvular atrial fibrillation(within 48 hours); baseline NT-proBNP levels are an important predictor of cardioversion. The higher baseline NT-proBNP levels is, the lower conversion rate will be. In order to avoid drug adverse events, a rate control strategy will be better than rhythm control in recent-onset atrial fibrillation with higher NT-proBNP levels. |
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