B-型钠尿肽对诊断中国心衰患者的系统评价  

Diagnosis of congestive heart failure by BNP

作　　者：韦虎 漆波 王德荣 余巍 魏朝阳 

机构地区：[1]江油市九○三医院,四川江油621700

出　　处：《西部医学》2010年第6期1046-1050,共5页Medical Journal of West China

摘　　要：目的评价B-型钠尿肽(BNP)在中国心衰患者中的诊断价值。方法以"BNP"、"脑利钠肽"、"心力衰竭"、"呼吸困难"、"诊断"、"诊断准确性"为检索词,检索中国期刊全文数据库、中国生物医学文献数据库,收集1989年1月至2009年12月国内正式刊物上公开发表的评价BNP检测诊断心衰准确性的相关文献。按确定的纳入、排除标准进行筛选,应用MetaDisc1.4软件进行Meta分析,综合评价灵敏度、特异度、似然比、诊断优势比和SROC曲线下面积、Q指数等指标。结果共27篇文献符合纳入标准,Meta分析结果显示采用盲法的10篇文献一致性较高,BNP诊断心衰的合并敏感度、特异度分别是0.92(95%CI:0.90,0.94)、0.89(95%CI:0.86,0.91);合并阳性似然比、阴性似然比分别为7.68(95%CI:5.72,10.31)、0.10(95%CI:0.07,0.13),诊断优势比及其95%CI为91.58(55.51,151.08),SROC曲线下面积AUC=0.9637,Q*=0.9101。结论 BNP用于诊断心衰患者准确度较高,具有临床应用价值。Objective To systemically evaluate the accuracy of BNP test for diagnosis of congestive heart failure.Methods Theses related to diagnosis of congestive heart failure in Chinese adult population by BNP test published from 1989-01 to 2009-12 were retrieved in CNKI and CBM.Data analysis was conducted by software of Meta-Disc1.4.Indexes reflecting accuracy of BNP test for diagnosis of congestive heart failure such as sensitivity,specificity,likelihood ratio,diadnostic odds ratio were pooled using fixed effect model.SROC（summary receiver operating characteristic） curve was used to summarize overall diagnostic performance.Results The whole 27 studies were highly heterogeneous,but the 10 studies which used blind observation were of homogeneous.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diadnostic odds ratio were 0.92（95%CI：0.90,0.94）,0.89（95%CI：0.86,0.91）,7.68（95%CI：5.72,10.31）,0.10（95%CI：0.07,0.13） and 91.58（55.51,151.08）.The area under SROC curve was 0.9649.Q index was 0.9117.Conclusion BNP test is a highly accurate method to diagnose congestive heart failure in Chinese adult population.

关 键 词：BNP 心衰 诊断 META分析 系统评价 

分 类 号：R541.6[医药卫生—心血管疾病]