中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
31期
31-34
,共4页
利钠肽,脑%运动试验%冠状动脉疾病
利鈉肽,腦%運動試驗%冠狀動脈疾病
리납태,뇌%운동시험%관상동맥질병
Natriuretic peptide,brain%Exercise testing%Coronary disease
目的 观察运动平板试验前后血浆B型尿钠肽(BNP)浓度变化,并评价BNP浓度的变化(ABNP)诊断冠心病的准确性.方法 拟诊冠心病患者188例,26例健康志愿者(C组),行运动平板试验,运动平板试验前后检测血浆BNP浓度.拟诊冠心病患者行冠状动脉造影,根据冠状动脉狭窄是否>50%,将拟诊冠心病患者分为冠心病组(A组,96例)和非冠心病组(B组,92例).结果运动平板试验后血浆BNP浓度较运动前明显升高,JP<0.01.A组ABNP中位数为20.9 pg/ml,较B组的7.3 pg/ml、C组的8.0pg/ml显著升高,P<0,01.当△BNP的水平设定在8.5 pg/ml时.诊断冠心病的灵敏度为93.5%,特异度为57.1%,阳性预测值为70.5%,阴性预测值为88.9%,曲线下面积(AUC)为0.815,95%可信区间为0.768～0.896.结论 运动平板试验后血浆BNP浓度较运动前明显升高;运动平板试验中ABNP设定在8.5 pg/ml时,诊断冠状动脉狭窄具有较高的灵敏度和特异度.
目的 觀察運動平闆試驗前後血漿B型尿鈉肽(BNP)濃度變化,併評價BNP濃度的變化(ABNP)診斷冠心病的準確性.方法 擬診冠心病患者188例,26例健康誌願者(C組),行運動平闆試驗,運動平闆試驗前後檢測血漿BNP濃度.擬診冠心病患者行冠狀動脈造影,根據冠狀動脈狹窄是否>50%,將擬診冠心病患者分為冠心病組(A組,96例)和非冠心病組(B組,92例).結果運動平闆試驗後血漿BNP濃度較運動前明顯升高,JP<0.01.A組ABNP中位數為20.9 pg/ml,較B組的7.3 pg/ml、C組的8.0pg/ml顯著升高,P<0,01.噹△BNP的水平設定在8.5 pg/ml時.診斷冠心病的靈敏度為93.5%,特異度為57.1%,暘性預測值為70.5%,陰性預測值為88.9%,麯線下麵積(AUC)為0.815,95%可信區間為0.768～0.896.結論 運動平闆試驗後血漿BNP濃度較運動前明顯升高;運動平闆試驗中ABNP設定在8.5 pg/ml時,診斷冠狀動脈狹窄具有較高的靈敏度和特異度.
목적 관찰운동평판시험전후혈장B형뇨납태(BNP)농도변화,병평개BNP농도적변화(ABNP)진단관심병적준학성.방법 의진관심병환자188례,26례건강지원자(C조),행운동평판시험,운동평판시험전후검측혈장BNP농도.의진관심병환자행관상동맥조영,근거관상동맥협착시부>50%,장의진관심병환자분위관심병조(A조,96례)화비관심병조(B조,92례).결과운동평판시험후혈장BNP농도교운동전명현승고,JP<0.01.A조ABNP중위수위20.9 pg/ml,교B조적7.3 pg/ml、C조적8.0pg/ml현저승고,P<0,01.당△BNP적수평설정재8.5 pg/ml시.진단관심병적령민도위93.5%,특이도위57.1%,양성예측치위70.5%,음성예측치위88.9%,곡선하면적(AUC)위0.815,95%가신구간위0.768～0.896.결론 운동평판시험후혈장BNP농도교운동전명현승고;운동평판시험중ABNP설정재8.5 pg/ml시,진단관상동맥협착구유교고적령민도화특이도.
Objective To observe the change of the concentration of plasma B-type natriuretic peptide (BNP) before and after treadmill exercise test (TET),and to judge the accuracy of BNP changes ( ABNP)in diagnosing coronary heart disease (CHD). Methods A total of 188 patients with suspected CHD underwent TET and the levels of plasma BNP before and after TET was detected. All the patients were divided into CHD group( group A, n = 96) and non-CHD group(group B, n = 92) according to coronary ar-teriography. Meanwhile, 26 healthy volunteers were enrolled (group C). Results The levels of plasma BNP after TET increased significantly (P<0.01 ). The levels of ABNP of group A were obviously higher than those of group B and C(P<0.01 ). When the levels of △BNP was 8.5 pg/ml, the sensibility, specificity, pos-itive predictive value and negative predictive value of diagnosing CHD was 93.5%, 57.1%, 70.5% and 88.9% respectively. Area under curve (AUC) was 0.815, and 95% confidence interval was 0.768-0.896.Conclusions The levels of plasma BNP after TET increase obviously. It exists higher sensibility and speci-ficity in diagnosing CHD by △ABNP set 8.5 pg/ml.
