目的 探讨外周血超敏C反应蛋白(hypersensitive C-reactive protein，hs-CRP)、氨基末端脑钠肽前体(N-terminal pro brain natriuretic peptide，NTpro-BNP)、肌钙蛋白(cardiacmuscle troponinT，cTnT)在心房颤动(atrial fibrillation，AF)患者术后复发预测中的价值。方法 选取2018年8月—2022年8月在泉州医学高等专科学校附属人民医院住院并治疗的81例AF患者作为AF组，另外选择同时间在泉州医学高等专科学校附属人民医院健康体检结果为窦性心律者81例作为对照组。比较2组患者的一般资料以及外周血生化指标(hs-CRP、NTpro-BNP、cTnT)水平。随访AF患者术后 1 年是否复发AF，将患者分为复发组(n=24)与未复发组(n=57)。采用logistic回归分析影响AF患者术后复发的相关因素，并绘制受试者工作特征(receiver operating characteristic，ROC)曲线评估hs-CRP、NTpro-BNP、cTnT对AF复发的预测价值。结果 AF组患者血清hs-CRP、NTpro-BNP、cTnT水平均高于对照组，差异有统计学意义(P＜0。05)。复发组和未复发组AF患者左室射血分数、左房内径、术中电复律比较，差异有统计学意义(P＜0。05)。复发组AF患者血清hs-CRP、NTpro-BNP、cTnT水平均高于未复发组，差异有统计学意义(P＜0。05)。logistic回归分析结果表明，血清hs-CRP(OR=1。697，P=0。015)、NTpro-BNP(OR=2。303，P=0。044)、cTnT水平(OR=3。476，P=0。041)均明显升高，是AF患者术后复发的独立危险因素(P＜0。05)。血清hs-CRP、NTpro-BNP、cTnT水平预测患者复发的ROC曲线下面积(area under curve，AUC)分别为0。736、0。757、0。790，敏感度分别为50。00%、70。83%、79。17%，特异度分别为91。23%、73。68%、68。42%。结论 外周血hs-CRP、NTpro-BNP、cTnT水平与AF的发生有关，对AF患者术后复发具有一定的预测价值。
The Value of Peripheral Blood hs-CRP,NTpro-BNP and cTnT in Predicting Postoperative Recurrence in Patients With Atrial Fibrillation
Objective To explore the value of peripheral blood hypersensitive C-reactive protein(hs-CRP),N-terminal pro brain natriuretic peptide(NTpro-BNP),and cardiac troponin T(cTnT)in predicting postoperative recurrence in patients with atrial fibrillation(AF).Methods A total of 81 AF patients who were hospitalized and treated in People's Hospital Affiliated of Quanzhou Medical College from August 2018 to August 2022 were selected as the AF group,and 81 healthy individuals with sinus rhythm who underwent physical examination in People's Hospital Affiliated of Quanzhou Medical College at the same time were selected as the control group.The general information and peripheral blood biochemical indicators(hs-CRP,NTpro-BNP,cTnT)levels between two groups of patients were compared.Follow up AF patients one year after surgery to determine if there was a recurrence of AF.The patients were divided into a recurrence group(n=24)and a non recurrence group(n=57).logistic regression analysis was used to identify the factors influencing postoperative recurrence in AF patients,and ROC curves were plotted to evaluate the predictive value of hs-CRP,NTpro-BNP,and cTnT for AF recurrence.Results The serum hs-CRP,NTpro-BNP,and cTnT levels in the AF group were higher than those in the control group,and the differences were statistically significant(P＜0.05).There were statistically significant differences in left ventricular ejection fraction,left atrial diameter,and intraoperative electroconversion between the recurrent group and the non recurrent group of AF patients(P＜0.05).The serum hs-CRP,NTpro-BNP and cTnT levels of AF patients in the recurrent group were higher than those in the non recurrent group,and the differences were statistically significant(P＜0.05).The results of logistic regression analysis showed that serum hs-CRP(OR=1.697,P=0.015),NTpro-BNP(OR=2.303,P=0.044),and cTnT levels(OR=3.476,P=0.041)were significantly elevated,and were independent risk factors for postoperative recurrence in AF patients(P＜0.05).The areas under the ROC curve(AUC)predicted by serum hs-CRP,NTpro-BNP and cTnT levels for predicting patient recurrence were 0.736,0.757,and 0.790,respectively,with sensitivity of 50.00%,70.83%,and 79.17%,specificity of 91.23%,73.68%,and 68.42%.Conclusion The levels of hs CRP,NTpro BNP and cTnT in peripheral blood are related to the occurrence of AF and have certain predictive value for postoperative recurrence in AF patients.
hypersensitive C-reactive proteintroponinamino-terminal brain natriuretic peptide precursoratrial fibrillationpostoperative recurrencepredictive value
万方数据
维普
