[心力衰竭中的利钠肽]
[Natriuretic peptides in heart failure].
作者信息
Emdin M, Poletti R, Giannoni A, Mazzei M G, Mammini C, Gabutti A, Agazio A, Caprioli R, Passino C
机构信息
U.O. Medicina Cardiovascolare, Istituto di Fisiologia Clinica del CNR, Pisa.
出版信息
G Ital Nefrol. 2006 Jan-Feb;23 Suppl 34:S32-7.
The recent discovery of cardiac endocrine function, together with the development of accurate and feasible assay methods for cardiac natriuretic hormone evaluation, i.e. for B-type natriuretic peptide (BNP) and inactive peptide NT-proBNP have confirmed their pathophysiological and clinical significance for cardiovascular disease assessment. Concerning heart failure, their value is for diagnostic screening in selected/unselected populations, for differential diagnosis of dyspnea and for prognostic stratification, and as a guide for follow-up and treatment of patients. Recent Italian recommendations pointed out that BNP/NT-proBNP has a role in ruling-out the diagnosis of heart failure in patients with dubious signs/symptoms: plasma BNP/NT-proBNP concentrations help in the clinical evaluation of chronic heart failure patients when risk stratification is needed, whereas the routine BNP/NT-proBNP assay is still not recommended to guide therapeutic decision-making.
心脏内分泌功能的最新发现，以及用于评估心脏利钠激素（即B型利钠肽（BNP）和无活性肽NT-proBNP）的准确可行的检测方法的发展，证实了它们在评估心血管疾病方面的病理生理和临床意义。关于心力衰竭，它们的价值在于在选定/未选定人群中进行诊断筛查、用于呼吸困难的鉴别诊断和预后分层，以及作为患者随访和治疗的指导。最近意大利的建议指出，BNP/NT-proBNP在排除体征/症状可疑患者的心力衰竭诊断中具有作用：当需要进行风险分层时，血浆BNP/NT-proBNP浓度有助于慢性心力衰竭患者的临床评估，而常规的BNP/NT-proBNP检测仍不建议用于指导治疗决策。
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