Zeng C, Wei T, Jin L, Wang L
Department of Cardiology, Lishui City Central Hospital, Zhejiang Province, China.
Intern Med J. 2006 Sep;36(9):552-7. doi: 10.1111/j.1445-5994.2006.01136.x.
B-type natriuretic peptide (BNP) is elevated in patients with end-stage renal failure. The reported accuracy of BNP in diagnosing left ventricular dysfunction in these patients has been inconsistent.
To investigate the diagnostic values of BNP for left ventricular dysfunction in patients undergoing haemodialysis for chronic renal failure.
We measured plasma BNP before and at 10 min and 3, 6 and 24 h after haemodialysis in 56 patients.
The average plasma BNP before haemodialysis was 284 +/- 369 pg/mL, which was higher than that of healthy subjects (37 +/- 37 pg/mL; n = 32, P < 0.01). The average plasma BNP in patients with left ventricular dysfunction (n = 21) was substantially higher than that in those with normal ventricular function before and at 10 min and 3, 6 and 24 h after haemodialysis (P < 0.001). The area under the receiver operating characteristic curves was greater than 0.895 before and at the four time points after haemodialysis (P < 0.01). Using 152 pg/mL as a cut-off value, predialysis BNP has 81% sensitivity and 83% specificity in diagnosing left ventricular dysfunction in these patients.
We concluded that plasma BNP offers a good sensitivity and specificity in diagnosing left ventricular dysfunction in patients with dialysis-dependent renal failure.
终末期肾衰竭患者的B型利钠肽（BNP）水平升高。关于BNP在诊断这些患者左心室功能障碍方面的准确性报道并不一致。
探讨BNP对慢性肾衰竭血液透析患者左心室功能障碍的诊断价值。
我们对56例患者在血液透析前、透析后10分钟以及3、6和24小时测量了血浆BNP。
血液透析前血浆BNP平均水平为284±369 pg/mL，高于健康受试者（37±37 pg/mL；n = 32，P < 0.01）。左心室功能障碍患者（n = 21）在血液透析前、透析后10分钟以及3、6和24小时的血浆BNP平均水平显著高于心室功能正常的患者（P < 0.001）。血液透析前及透析后四个时间点的受试者工作特征曲线下面积均大于0.895（P < 0.01）。以152 pg/mL作为临界值，透析前BNP诊断这些患者左心室功能障碍的灵敏度为81%，特异度为83%。
我们得出结论，血浆BNP在诊断依赖透析的肾衰竭患者左心室功能障碍方面具有良好的灵敏度和特异度。
