血清PDGF联合BNP预测非体外循环冠状动脉搭桥术患者术后新发心房颤动的临床价值
Clinical value of platelet derived growth factor combined with brain natriuretic peptide in predicting new-onset atrial fibrillation after off-pump coronary artery bypass grafting
姜丽杰 1刘兆汛 1张新花 1赵竞余1
作者信息
- 1. 056002 邯郸,邯郸市中心医院心血管外科
- 折叠
摘要
目的 探讨血小板源性生长因子(PDGF)联合血清脑钠肽(BNP)预测非体外循环冠状动脉搭桥术(OPCABG)患者术后新发心房颤动(房颤)的临床价值.方法 选取2021年1月至2023年1月于邯郸市中心医院心血管外科收治的197例择期行OPCABG术的患者作为研究对象.所有患者于术前检测血清PDGF水平(酶联免疫吸附法)和血清BNP水平(放射免疫法).根据患者术后住院期间是否发生房颤分为新发房颤组(n=37)和非新发房颤组(n=160).采用受试者工作特性(ROC)曲线评估血清PDGF、BNP对OPCABG患者术后是否新发房颤的预测价值;采用多因素Logistic回归分析探讨OPCABG患者术后新发房颤的影响因素.结果 新发房颤组血清BNP、PDGF水平高于非新发房颤组(P＜0.05).新发房颤组患者年龄、右冠状动脉狭窄率、术后主动脉内球囊反搏(IABP)辅助比例、机械通气时间、空腹血糖(FPG)、左心房容积指数(LAVI)均高于非新发房颤组,左室射血分数(LVEF)低于非新发房颤组(P＜0.05).多因素Logistic回归分析显示,右冠状动脉近段狭窄≥75%(OR=2.090,95%CI:1.495～2.922)、BNP≥287.64 pg/ml(OR=2.746,95%CI:1.798～4.193)、PDGF≥398.57μg/L(OR=2.601,95%CI:1.765～3.835)是OPCABG患者术后发生房颤的影响因素(P＜0.05).血清BNP、PDGF预测OPCABG患者术后新发房颤的AUC(95%CI)分别为0.781(0.756～0.818)、0.825(0.797～0.861),两者联合预测的AUC(95%CI)为0.901(0.874～0.935).结论 OPCABG术后新发房颤患者血清PDGF、BNP水平均升高,二者可作为OPCABG患者术后新发房颤的预测指标,且联合检测预测效能更高,可为临床早期治疗提供依据.
Abstract
Objective To investigate the clinical value of platelet derived growth factor(PDGF)combined with brain natriuretic peptide(BNP)in predicting new-onset atrial fibrillation(AF)in patients undergone off-pump coronary artery bypass grafting(OPCABG).Methods The patients(n=197)undergone OPCABG were chosen from Department of Cardiovascular Surgery in Handan Central Hospital from Jan.2021 to Jan.2023.The levels of serum PDGF(enzyme-linked immunosorbent assay)and BNP(radioimmunoassay)were detected in all patients before the operation.The patients were divided,according to whether they had AF or not during hospitalization,into new-onset AF group(n=37)and non-new-onset AF group(n=160).The predictive value of PDGF and BNP to new-onset AF was reviewed by using ROC curve analysis in patients after OPCABG.The influence factors of new-onset AF were discussed by using multi-factor Logistic regression analysis in patients after OPCABG.Results The levels of serum BNP and PDGF were higher in new-onset AF group than those in non-new-onset AF group(P<0.05).Age,right coronary artery stenosis rate,assisted ratio of postoperative intra-aortic balloon pumps(IABP),mechanical ventilation(MV)time,fasting plasma glucose(FPG)and left atrial volume index(LAVI)were higher,and left ventricular ejection fraction(LVEF)was lower in new-onset AF group than those in non-new-onset AF group(P<0.05).The results of multi-factor Logistic regression analysis showed that proximal right coronary artery stenosis≥75%(OR=2.090,95%CI:1.495～2.922),BNP≥287.64 pg/ml(OR=2.746,95%CI:1.798～4.193)and PDGF≥398.57 μg/L(OR=2.601,95%CI:1.765～3.835)were influence factors of postoperative new-onset AF after OPCABG.The AUC of BNP was 0.781(95%CI:0.756～0.818),AUC of PDGF was 0.825(95%CI:0.797～0.861)and AUC of BNPcombined with PDGF was 0.901(95%CI:0.874～0.935)in predicting postoperative new-onset AF after OPCABG.Conclusion The levels of serum PDGF and BNP increase in patients with new-onset AF after OPCABG,and they can be taken as the predictive indicators for new-onset AF after OPCABG.The predictive efficacy of PDGF combined with BNP is higher,which can provide basis for early treatment in clinical practice.
关键词
血小板源性生长因子/脑钠肽/非体外循环冠状动脉搭桥术/心房颤动/预测价值Key words
Platelet derived growth factor/Brain natriuretic peptide/Off-pump coronary artery bypass grafting/Atrial fibrillation/Predictive value引用本文复制引用
基金项目
河北省邯郸市科学技术研究与发展计划项目(1823208048ZC)
出版年
2024
NETL
NSTL
万方数据