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目的观察心房颤动(简称房颤)患者血浆心房钠尿肽(ANP)和C型钠尿肽(CNP)水平的变化,及其与心脏结构改变的相关性,从而进一步分析ANP、CNP在房颤心房结构重构中的作用。方法入选左心功能正常的房颤患者及无房颤对照组。房颤患者又根据房颤持续时间不同分为阵发性房颤(Paf)组及持续性房颤(Peaf)组。采用酶联免疫吸附法检测血浆ANP和CNP水平,并采用超声心动图测量舒张期左房内径、左室内径、室间隔厚度及左室后壁厚度,并计算左室质量指数。结果入选对照组57例,和房颤组62例(其中Paf组35例,Peaf组27例)。年龄、性别等临床背景资料均无差异,具有可比性。房颤组的血浆ANP和CNP水平明显高于对照组[ANP:(728.1±336.9)pg/ml vs(524.6±165.3)pg/ml,P=0.000;CNP:(114.2±28.6)pg/ml vs(97.1±22.4)pg/ml,P=0.000],且与左房内径明显正相关(ANP:r=0.389,P=0.001;CNP:r=0.344,P=0.004)。此外,ANP与CNP之间呈明显的相关性(r=0.799,P=0.000),CNP与室间隔厚度(r=0.343,P=0.006)、左室后壁厚度(r=0.308,P=0.013)、左室质量指数(r=0.275,P=0.030)相关。结论 ANP和CNP与左房扩大明显相关,可能参与心脏重构的过程。
Objective To observe the changes of plasma atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) in patients with atrial fibrillation (AF) and its relationship with changes of cardiac structure, so as to further analyze the relationship between ANP and CNP in atrial fibrillation Atrial structural remodeling. Methods Atrial fibrillation patients with normal left ventricular function and control group without atrial fibrillation were enrolled. Atrial fibrillation patients were divided into paroxysmal atrial fibrillation (Paf) group and persistent atrial fibrillation (Peaf) group according to the duration of atrial fibrillation. Plasma ANP and CNP levels were measured by enzyme-linked immunosorbent assay. Left atrial diameter, left ventricular diameter, interventricular septum thickness and left ventricular posterior wall thickness were measured by echocardiography, and left ventricular mass index was calculated. Results A total of 57 patients were enrolled in the control group and 62 patients in the AF group (35 in the Paf group and 27 in the Peaf group). Age, gender and other clinical background information were no difference, comparable. Plasma ANP and CNP levels in AF group were significantly higher than those in control group [ANP: (728.1 ± 336.9) pg / ml vs (524.6 ± 165.3) pg / ml, P = 0.000; CNP: (114.2 ± 28.6) pg / (97.1 ± 22.4) pg / ml, P = 0.000], and positively correlated with left atrial diameter (ANP: r = 0.389, P = 0.001; CNP: r = 0.344, P = 0.004). In addition, there was a significant correlation between ANP and CNP (r = 0.799, P = 0.000), CNP and interventricular septum thickness (r = 0.343, P = 0.006) ), Left ventricular mass index (r = 0.275, P = 0.030). Conclusions ANP and CNP are significantly associated with left atrial enlargement and may be involved in the process of cardiac remodeling.