[經(jīng)典]血漿腦型鈉利尿肽在維持性血液透析患者左室舒張功能障礙診斷中的價(jià)值

《[經(jīng)典]血漿腦型鈉利尿肽在維持性血液透析患者左室舒張功能障礙診斷中的價(jià)值》由會(huì)員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在工程資料-天天文庫。

1、［經(jīng)典］血漿腦型鈉利尿肽在維持性血液透析患者左室舒張功能障礙診斷中的價(jià)值血漿腦型鈉利尿肽在維持性血液透析患者左室舒張功能障礙診斷中的價(jià)值［摘要］目的:探討血漿腦型鈉利尿肽(BNP)在維持性血透(MHD)患者左心室舒張功能障礙(LVDD)中的診斷價(jià)值。方法:MHD患者59例，透析前行心臟多普勒組織成像檢測(cè)，按不同舒張?jiān)缙诜逯邓俣?Ve)與舒張晚期峰值速度(Va)的比值分為L(zhǎng)VDD組(Vc/Va〈l)和左心室舒張功能正常組(Ve/Va^1)兩組。同時(shí)檢測(cè)透析前血漿BNP、血常規(guī)及生化指標(biāo)、超敏C反應(yīng)蛋白(hs-CR

2、P)、甲狀旁腺激素(PTH)等。結(jié)果:LVDD組與左心室舒張功能正常組相比,BNP>hs-CRP、收縮壓顯著性升高，血紅蛋白(Hb)顯著性降低(P〈0?05)oMHD患者的BNP水平與hs-CRP、收縮壓、舒張壓等顯著止相關(guān)，與Hb顯著負(fù)相關(guān)。BNP診斷MHD患者LVDD的曲線下面積(AUC)為0.86(95%CI:0.76、0?96),353.6pg•ml-l作為界值的靈敏度為80%,特異度為85%。結(jié)論:BNP水平升高對(duì)MHD患者合并LVDD可能具有重要的診斷價(jià)值。?［關(guān)鍵詞］腦型鈉利尿肽；多普

3、勒組織成像；左心室舒張功能障礙；血液透析?［中圖分類號(hào)］R541.9;R692.5：文獻(xiàn)標(biāo)識(shí)碼］A［文章編號(hào)］1671-7562(2010)01-0036-04?doi:10.3969/j.issn.1671-7562.2010.01.010??ClinicalvalueofB-natriureticpeptideinthediagnosisofleftventriculardiastolicdysfunctioninmaintenancehemodialysispatientswithnormalejecti

4、onfraction??ZHANGYing-zil,2,LIUHong^l,GAOMin?1,LIUBi-cheng01(1.SchoolofClinicalMedicine,SoutheastUniversity,Nanjing210009,China;2.InstituteofNephrology,JiangyinHospital,SoutheastUniversity,Jiangyin214400,China)??[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