| 曹大平,张 峰,张蔚菁,李明飞,周达新.心房颤动患者血清NT-ProBNP、UA、MCP-1与心房纤维化标志物的相关性及对射频消融术后复发的预测价值[J].,2022,(12):2361-2365 |
| 心房颤动患者血清NT-ProBNP、UA、MCP-1与心房纤维化标志物的相关性及对射频消融术后复发的预测价值 |
| Correlation between Serum NT-ProBNP, UA, MCP-1 and Atrial Fibrosis Markers in Patients with Atrial Fibrillation and the Predictive Value of Recurrence after Radiofrequency Ablation |
| 投稿时间：2021-11-22 修订日期：2021-12-17 |
| DOI：10.13241/j.cnki.pmb.2022.12.033 |
| 中文关键词: 心房颤动 NT-ProBNP UA MCP-1 心房纤维化 复发 预测价值 |
| 英文关键词: Atrial fibrillation NT-ProBNP UA MCP-1 Atrial fibrosis Recurrence Predictive value |
| 基金项目:上海市科委基金项目（14ZR1406700） |
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| 中文摘要: |
| 摘要 目的：探讨心房颤动（AF）患者血清氨基末端B型脑钠肽前体（NT-ProBNP）、尿酸（UA）、单核细胞趋化蛋白1（MCP-1）与心房纤维化标志物的相关性及对射频消融术后复发的预测价值。方法：选择我院2019年1月～2021年1月收治的140例AF患者，记作AF组，另取同期健康体检人员140例作为对照组，检测并比较两组血清NT-ProBNP、UA、MCP-1与心房纤维化标志物水平，并分析相关性。所有AF患者均行射频消融术治疗，并按照随访结果的差异分作复发组和未复发组，采用多因素Logistic回归分析AF患者射频消融术后复发的影响因素。借助受试者工作特征（ROC）曲线分析血清NT-ProBNP、UA、MCP-1预测AF患者射频消融术后复发的效能。结果：AF组血清NT-ProBNP、UA、MCP-1以及Ⅰ型胶原羧基端前肽（PⅠCP）、Ⅲ型胶原前多肽（PⅢNP）、透明质酸（HA）水平均高于对照组（P＜0.05）。Pearson相关性分析结果显示：血清NT-ProBNP、UA、MCP-1水平与PⅠCP、PⅢNP、HA水平均呈正相关（P＜0.05）。单因素分析结果显示：AF患者射频消融术后是否复发与年龄、病程、体质量指数（BMI）及血清NT-ProBNP、UA、MCP-1水平有关（P＜0.05），而与性别无关（P＞0.05）。多因素Logistic回归分析结果显示：年龄较大、病程较长、BMI以及血清NT-ProBNP、UA、MCP-1水平较高是AF患者射频消融术后复发的危险因素（P＜0.05）。ROC曲线分析结果显示：血清NT-ProBNP、UA、MCP-1水平联合检测预测AF患者射频消融术后复发的曲线下面积为0.894，明显高于各指标单独检测的0.654、0.672、0.681。结论：AF患者血清NT-ProBNP、UA、MCP-1水平与心房纤维化密切相关，且对AF患者射频消融术后是否复发具有一定的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between serum N-terminal pro brain natriuretic peptide (NT-ProBNP), uric acid (UA), monocyte chemoattractant protein-1 (MCP-1) and atrial fibrosis markers in patients with atrial fibrillation (AF) and its predictive value for recurrence after radiofrequency ablation. Methods: 140 patients with AF who were admitted to the hospital from January 2019 to January 2021 were selected, which were recorded as AF group. Another 140 healthy physical examination personnel in the same period were taken as the control group. The levels of serum NT-ProBNP, UA, MCP-1 and atrial fibrosis markers were detected and compared between the two groups, and the correlation was analyzed. Radiofrequency ablation was performed on all patients with AF, and they were divided into the recurrence group and the non-recurrence group according to the difference of follow-up results. Multivariate Logistic regression was used to analyze the influencing factors of recurrence after radiofrequency ablation in patients with AF. The efficacy of serum NT-ProBNP, UA and MCP-1 in predicting recurrence after radiofrequency ablation in patients with AF was analyzed by receiver operating characteristic (ROC) curve. Results: The levels of serum NT-ProBNP, UA, MCP-1, type Ⅰ collagen carboxy-terminal propeptide (PⅠCP), type Ⅲ collagen propeptide (PⅢNP) and hyaluronic acid (HA) in AF group were higher than those in control group (P＜0.05). Pearson correlation analysis showed that the levels of serum NT-ProBNP, UA and MCP-1 were positively correlated with the levels of PⅠCP, PⅢNP and HA (P＜0.05). Univariate analysis showed that the recurrence of patients with AF after radiofrequency ablation was correlated with age, course of disease, body mass Index (BMI) and levels of serum NT-ProBNP, UA and MCP-1 (P＜0.05), but not with gender (P＞0.05). Multivariate Logistic regression analysis showed that older age, longer course of disease, BMI and higher levels of serum NT-ProBNP, UA and MCP-1 were risk factors for patients with AF of recurrence after radiofrequency ablation (P＜0.05). ROC curve analysis results showed that the area under curve of combined detection of levels of serum NT-ProBNP, UA and MCP-1 in predicting the patients with AF of recurrence after radiofrequency ablation was 0.894, which was significantly higher than 0.654, 0.672 and 0.681 of each index alone. Conclusion: The levels of serum NT-ProBNP, UA and MCP-1 in patients with AF are closely related to atrial fibrosis, and have certain predictive value for patients with AF of recurrence after radiofrequency ablation. |
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