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左室功能不全患者血清脑钠尿肽的水平及诊断价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第6期
页码:
562-563,566
栏目:
临床研究
出版日期:
2004-11-01

文章信息/Info

Title:
Level of serum brain natriuretic peptide in lef t ventricular dysfunction and its diagnostic value
作者:
缪克强1; 王建安2
1. 苍南县第二人民医院心内科, 浙江苍南325802 ;2. 浙江大学医学院附属邵逸夫医院心内科, 浙江杭州310016
Author(s):
MIAO Ke-qiang1; WANG Jian-an2
1. Department of Cardiology , Second People’s Hospital of Cangnan ,Cangnan ,Zhejiang 325802 ,China ; 2. Department of Cardiology , Affiliated Sir Run Run Shaw Hospital of Zhejiang University ,Hangzhou ,Zhejiang 310016 ,China
关键词:
功能不全; 左室;  脑钠尿肽;  诊断
Keywords:
left vent ricular dysfunction ;  brain nat riuretic peptide ;  diagnosis
分类号:
R541
DOI:
-
文献标识码:
A
摘要:
目的:探讨左室功能不全(LVD) 患者血清脑钠尿肽(BNP) 水平和诊断价值。方法:用EL ISA 法测定单纯左室舒张功能不全(LVDD) 患者30 例、左室收缩功能不全(LVSD 伴或不伴舒张功能不全) 患者15 例、心功能正常者(健康对照组) 血清BNP 浓度20 例,并按诊断试验的评价方法计算真实性指标。结果:LVDD 组BNP 水平明显高于健康组(210 ±134 ng/ L vs 72 ±32 ng/ L , P < 0. 05) ,但明显低于LVSD 组(210 ±134 ng/ L vs 1086 ±519 ng/ L , P < 0.05) 。以BNP ≥120 ng/ L 为截断点,诊断LVD 的灵敏度和特异度分别为91 %和95 % ,准确度为92 %;判断单纯LVDD 灵敏度为87 % ,特异度为95 %。结论:LVD 患者血清BNP 浓度明显升高,是较好的诊断指标,但单纯LVDD患者升高程度不如LVSD 患者;若左室收缩功能正常,BNP 水平≥120 ng/ L 高度提示LVDD 存在的可能。
Abstract:
AIM: To investigate the level of serum brain nat riuretic peptide (BNP) in patient s with left vent ricular dysfunction (LVD) and it s diagnostic value . METHODS : BNP levels were measured by EL ISA in 30 cases with pure left vent ricular diastolic dysfunction ( LVDD group) , 15 with left vent ricular systolic dysfunction combining or not with diastolic dysfunction (LVSD group) ,and 20 with normal cardiac function (health group) . RESULTS: BNP level in LVDD group was markedly higher than that in health group (210 ±134 ng/ L vs 72 ±32 ng/ L , P < 0. 05) ,but significantly lower than that in LVSD group (210 ±134 ng/ L vs 1086 ±519 ng/ L , P < 0. 05) . A cutoff value of 120 ng/ L had a sensitivity of 91 percent , a specificity of 95 percent and an accuracy of 92 percent for diagnosing left vent ricular dysfunction (LVD) ; BNP level > 120 ng/ L had a sensitivity of 87 percent , a specificity of 95 percent , a positive predictive value of 96 percent ,and a negative predictive value of 83 percent for determining pure LVDD. CONCLUSION: Serum BNP level in patient s with LVD has markedly elected , but was not as significant as LVSD. Given normal left vent ricular systolic function , BNP level > 120 ng/ L st rongly indicated the probable existence of LVDD.

参考文献/References

[1] 中华医学会心血管病学分会. 慢性收缩性心力衰竭治疗建议[J ] . 中国循环杂志,2002 ,17 (4) :248 - 263.

[2 ] Maisel A , Koon J , Krishnaswamy P , et al . Utility of B-natriuretic peptide as a rapid point-of-care test for screening patients undergoing echocardiography to determine left ventricular dysfunction [J ] .A m Heart J ,2001 ,141 :367 - 374.

[ 3 ] 孙长生. 筛检与诊断试验的评价[A] . 李良寿,李远贵,孙长生.临床医学研究原理与方法[M] . 西安: 陕西科学技术出版社,2000. 179 - 184.

[ 4 ] Hirata Y,Matsumoto A ,Aigigo T , et al . Measurement of plasma brain natriuretic peptide level as a guide for cardiac overload [ J ] .Cardiovasc Res ,2001 ,51 :585 - 591.

[ 5 ] Groenning BA , Nilsson JC , Sondergaard L , et al . Evaluation of impaired left ventricular ejection fraction and increased dimensions by multiple neurohumoral plasma concentrations [J ] . Eur J Heart Fail ,2001 ,3 :699 - 708.

备注/Memo

备注/Memo:
收稿日期：2004-4-14
更新日期/Last Update: 2004-11-01