B型钠尿肽预测老年非心脏手术心血管事件的价值  

Prediction of B-type Natriuretic Peptide for Cardiac Events after Noncardiac Surgery in Aged Patients

作　　者：肖军[1] 唐发宽[1] 李进 王洪叶[1] 李晓斌[1] 布伦[1] 张伟[1] 陆宏[1] 

机构地区：[1]解放军第309医院心内科,北京市100091 [2]总参政治部看守所,北京市102202

出　　处：《中国康复理论与实践》2009年第9期855-856,共2页Chinese Journal of Rehabilitation Theory and Practice

基　　金：解放军第309医院(原解放军总医院第二附属医院)科技立项资助项目(2007AM018)

摘　　要：目的探讨B型钠尿肽(BNP)评价老年非心脏手术心血管事件的价值。方法比较分析BNP、Goldman评分与ACC/AHA指南心脏风险分级3种方法对274例老年非心脏手术中评价心血管事件的价值。结果术前血浆BNP浓度>100pg/ml、Goldman评分≥13和ACC/AHA指南中高危级与心脏事件发生有关(P<0.01)。BNP与心脏风险分级判断心血管事件的灵敏度、特异度、准确度、阳性预告值、阴性预告值等指标无显著性差异(P>0.05);与Goldman评分相比较,BNP判断心脏事件灵敏度(100%比55.6%)和阴性预告值高(100%比96.3%)。结论术前血浆BNP浓度可较好地评价老年非心脏手术患者心脏事件的发生。Objective To explore the value of B-type natriuretic peptide （BNP） predicting cardiac events after noncardiac surgery in the aged patients. Methods The level of BNP, the score of Goldman analysis and the cardiac risk grade of ACC/AHA guideline were analyzed in 274 aged patients for cardiac outcome after noncardiac surgery. Results Preoperative BNP concentration〉 100 pg/ml, score of Goldman≥13 ,and the high or moderate risk grade by ACC/AHA guideline were related with cardiac events. There was no significant difference in the index such as sensitivity, specificity, accuracy,positive predictive value and negative predictive value for cardiac events between BNP level and cardiac risk grade. Compared with the score of Goldman, BNP was more sensitive （100 vs 55.6%）and negatively predictive （100% vs 96.3%） for cardiac events. Conclusion The risk of cardiac events after noncardiac surgery could be predicted with the level of BNP before operation in the aged patient.

关 键 词：B型钠尿肽(BNP) 老年人 非心脏手术 心脏事件 

分 类 号：R541.4[医药卫生—心血管疾病]