脑利钠肽对急性缺血性脑卒中后阵发性房颤的预测价值

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摘要目的探讨脑利钠肽（BNP）对急性缺血性脑卒中后阵发性心房颤动（以下简称“房颤”）的预测价值。方法回顾性分析2016年10月~2017年6月于武汉大学人民医院住院的急性缺血性脑卒中患者130例。根据入院时有无房颤或有无房颤病史，将患者分为房颤组和窦性心律组。窦性心律组在入院后7 d内行24小时动态心电图监测有无房颤。根据住院期间是否发生房颤，将窦性心律组患者分为新发房颤组和无房颤组。入院24 h内测定血浆BNP水平，多因素Logistic回归分析急性缺血性脑卒中后新发房颤的危险因素。结果本研究共纳入130例急性缺血性脑卒中患者，其中窦性心律患者80例，房颤患者50例。80例窦性心律患者术后行24小时动态心电图检查，其中新发房颤14例，无房颤66例。多因素Logistic回归分析显示，BNP是急性缺血性脑卒中后新发房颤的危险因素（OR = 1.163，95%CI：1.042~1.297，P = 0.007）。结论 BNP可以预测急性缺血性脑卒中后阵发性房颤的发生。

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	袁明杰1 毕继宏2

关键词 ：脑利钠肽, 缺血性脑卒中, 阵发性房颤, 预测价值

Abstract：Objective To investigate the predictive value of brain natriuretic peptide (BNP) for paroxysmal atrial fibrillation after acute ischemic stroke ("atrial fibrillation" for short). Methods A retrospective analysis of 130 patients with acute ischemic stroke admitted to Renmin Hospital of Wuhan University from October 2016 to June 2017 was performed. Patients were divided into atrial fibrillation group and sinus rhythm group according to whether there was atrial fibrillation or a history of atrial fibrillation at admission. The sinus rhythm group underwent 24-hour dynamic electrocardiogram monitoring for atrial fibrillation within 7 days after admission. Patients with sinus rhythm were divided into new atrial fibrillation group and non-atrial fibrillation group according to whether atrial fibrillation occurred during hospitalization. Plasma BNP levels were measured within 24 h after admission, and multivariate Logistic regression analysis was used to analyze the risk factors of new atrial fibrillation after acute ischemic stroke. Results A total of 130 patients with acute ischemic stroke were included in this study, including 80 patients with sinus rhythm and 50 patients with atrial fibrillation. Eighty patients with sinus rhythm underwent 24-hour dynamic electrocardiogram examination. Among them, 14 cases had new atrial fibrillation and 66 cases had no atrial fibrillation. Multivariate Logistic regression analysis showed that BNP was a risk factor for new atrial fibrillation after acute ischemic stroke (OR = 1.163, 95%CI: 1.042-1.297, P = 0.007). Conclusion BNP can predict the occurrence of paroxysmal atrial fibrillation after acute ischemic stroke.

Key words： Brain natriuretic peptide Ischemic stroke Paroxysmal atrial fibrillation Predictive value

基金资助:国家自然科学基金资助项目（81300105）。

作者简介: 袁明杰（1983-），男，博士，副教授；研究方向：心脏重构基础与临床研究。

引用本文:

袁明杰1 毕继宏2. 脑利钠肽对急性缺血性脑卒中后阵发性房颤的预测价值[J]. 中国医药导报, 2019, 16(16): 76-79.
YUAN Mingjie1 BI Jihong2. Predictive value of brain natriuretic peptide for paroxysmal atrial fibrillation after acute ischemic stroke. 中国医药导报, 2019, 16(16): 76-79.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I16/76

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