床边快速测定B型尿钠肽预测左心室收缩舒张功能  

Rapid bedside B-type natriuretic peptide assay predicts left ventriclar systolic and diastolic function

作　　者：曾春来[1] 韦铁民[1] 赵瑞英[1] 陈群英[1] 陈礼平[1] 吕玲春[1] 吕干新[1] 

机构地区：[1]温州医学院附属第五医院丽水市中心医院心内科,浙江丽水323000

出　　处：《中国心血管杂志》2005年第1期23-25,共3页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　评估床边快速测定B型尿钠肽 (BNP)预测左心室收缩舒张功能的价值。方法　对 2 16例患者行免疫荧光法床边快速测定BNP ,随后进行超声心动图检查 ,根据临床及超声心动图结果将患者分成左心室功能正常组 ,左心室舒张功能不全组和左心室收缩功能不全组。比较各组间BNP值及计算BNP对预测左心室收缩舒张功能不全的敏感性和特异性。结果　左心室功能正常组BNP值为 (31± 2 7) pg/ml,收缩功能不全组为 (5 18± 4 2 7)pg/ml,舒张功能不全组为 (12 4± 78) pg/ml。左心室收缩功能不全时BNP与左心室射血分数有较强的负相关 ,(R =- 0 .731,P <0 .0 0 1)。BNP预测左心室收缩功能不全的接受运行特征 (ROC)曲线下面积为 0 .96 ,以BNP≥ 10 0 pg/ml预测心力衰竭的敏感性为 90 % ,特异性为 91%。BNP预测左心室舒张功能不全的ROC曲线下面积为 0 .90 4。以BNP≥ 4 0pg/ml来预测左心室舒张功能不全的敏感性为 79% ,特异性为 92 %。 结论　床边测定BNP能快速可靠地预测左心室收缩舒张功能。Objective To investigate the value of rapid bedside B-type natriuretic peptide(BNP) assay in predicting left ventricular systolic and diastolic function. Methods 216 patients underwent rapid bedside BNP assay and then echocardiography. According to clinic manifestation and echocardiography, the patients were classified into three groups: normal left ventricular function, left ventricular systolic dysfunction and left ventricular diastolic dysfunction. BNP levels were compared and the sensibility and specificity of BNP were analyzed in predicting left ventricular systolic and diastolic dysfunction. Results BNP levels were(31±27)pg/ml in those with normal left ventricular function, (518±427)pg/ml in those with left ventricular systolic dysfunction and (124±78)pg/ml in those with left ventricular diastolic dysfunction. There was a strong negative relationship between BNP levels and left ventricle ejection fraction in those with left ventricular systolic dysfunction (R=-0.731, P<0.001). At a cutoff of 100pg/ml, the area under the receiver-operating-characteristic (ROC) curve of BNP predicting left ventricular systolic dysfunction was 0.96 with a sensitivity of 90% and specificity of 91% respectively. At a cutoff of 40pg/ml, the area under ROC curve of BNP predicting left ventricular diastolic dysfunction was 0.904 with a sensitivity of 79% and specificity of 92% respectively. Conclusion Rapid bedside BNP assay is able to rapidly and reliably predict left ventricular systolic and diastolic function.

关 键 词：B型尿钠钛 超声心动图 左心室收缩功能不全 左心室舒张功能不全 

分 类 号：R446.6[医药卫生—诊断学]