[经典]血浆脑型钠利尿肽在维持性血液透析患者左室舒张功能障碍诊断中的价值

《[经典]血浆脑型钠利尿肽在维持性血液透析患者左室舒张功能障碍诊断中的价值》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、［经典］血浆脑型钠利尿肽在维持性血液透析患者左室舒张功能障碍诊断中的价值血浆脑型钠利尿肽在维持性血液透析患者左室舒张功能障碍诊断中的价值［摘要］目的:探讨血浆脑型钠利尿肽(BNP)在维持性血透(MHD)患者左心室舒张功能障碍(LVDD)中的诊断价值。方法:MHD患者59例，透析前行心脏多普勒组织成像检测，按不同舒张早期峰值速度(Ve)与舒张晚期峰值速度(Va)的比值分为LVDD组(Vc/Va〈l)和左心室舒张功能正常组(Ve/Va^1)两组。同时检测透析前血浆BNP、血常规及生化指标、超敏C反应蛋白(hs-CR

2、P)、甲状旁腺激素(PTH)等。结果:LVDD组与左心室舒张功能正常组相比,BNP>hs-CRP、收缩压显著性升高，血红蛋白(Hb)显著性降低(P〈0・05)oMHD患者的BNP水平与hs-CRP、收缩压、舒张压等显著止相关，与Hb显著负相关。BNP诊断MHD患者LVDD的曲线下面积(AUC)为0.86(95%CI:0.76、0・96),353.6pg•ml-l作为界值的灵敏度为80%,特异度为85%。结论:BNP水平升高对MHD患者合并LVDD可能具有重要的诊断价值。❷［关键词］脑型钠利尿肽；多普

3、勒组织成像；左心室舒张功能障碍；血液透析❷［中图分类号］R541.9;R692.5：文献标识码］A［文章编号］1671-7562(2010)01-0036-04❷doi:10.3969/j.issn.1671-7562.2010.01.010❷❷ClinicalvalueofB-natriureticpeptideinthediagnosisofleftventriculardiastolicdysfunctioninmaintenancehemodialysispatientswithnormalejecti

4、onfraction❷❷ZHANGYing-zil,2,LIUHong^l,GAOMin❷1,LIUBi-cheng01(1.SchoolofClinicalMedicine,SoutheastUniversity,Nanjing210009,China;2.InstituteofNephrology,JiangyinHospital,SoutheastUniversity,Jiangyin214400,China)❷❷[Abstract]Objective:Toevaluatethediagnosticval

5、ueofB-natriureticpeptide(BNP)inthediagnosisofleftventriculardiastolicdysfunction(LVDD)inmaintenancehemodialysis(MUD)patientswithnormalejectionfraction.Methods:Thestudypopulationcomprised59MHDpatientswithnormalejectionfraction.Theratioofearlytolateannularvelo

6、city(Ve/Va)wasdeterminedasaparameterofdiastolicfunction.PlasmaBNPlevelsandserumhighsensitivityC-reactiveprotein(hs-CRP),parathyroidhormone(PTII)levelswereassayedwithacommerciallyavailablekit・Results:PlasmaBNPlevelsweresignificantlyhigherinpatientswithLVDDtha

7、nthatinpersonswithoutLVDD(P<0.01).PlasmaBNPlevelssignificantlycorrelatedwithhs-CRP(r=0.280,P=0.031),systolicbloodpressure(r=0.285,P二0.029),diastolicbloodpressure(r=0.259,P二0.048)andhemoglobin(lib)(r=~0.33&P二0.009)・Theareaunderthereceiver-operatingcharacteris

8、ticcurveforBNPtodetectLVDDwas0.86(95%CI:0.76to0.96;P<0.001).ABNPvalueof353.6pg•ml-lhadasensitivityof80%andaspecificityof85%fordetectingdiastolicdysfunction.Conclusion:IncreasedlevelsofBNPw