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唾液B型利钠肽:一种用于心力衰竭诊断和随访的新方法。

Salivary B-type natriuretic peptide: a new method for heart failure diagnosis and follow-up.

作者信息

Joharimoghadam Adel, Tajdini Masih, Bozorgi Ali

机构信息

Faculty of Medicine, AJA University of Medical Sciences, Shahid Etemadzadeh Ave., West Fatemi St., Tehran, Iran Department of Cardiology, Tehran Heart Centre, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Kardiol Pol. 2017;75(1):71-77. doi: 10.5603/KP.a2016.0097. Epub 2016 Jun 14.

Abstract

BACKGROUND

Frequent hospital admissions and reduced quality of life are the main complications of heart failure (HF). Plasma B-type natriuretic peptide (BNP) levels have been considered as a cost-effective method of screening for left ventricular dys-function. Studies regarding BNP-guided therapy revealed reduction in death or hospital stay for HF.

AIM

As saliva has fewer limitations than blood in regard to sampling, the aim of the present study was to test if salivary BNP concentration might be a new biomarker in patients with chronic HF.

METHODS

This pilot study involved 35 admitted patients with decompensated HF diagnosis and 35 HF patients who had come for a check-up at the Department of Cardiology. The control group consisted of 25 people with no history of cardiac events. Saliva and plasma samples of all the participants were collected.

RESULTS

Mean plasma NT-proBNP was found at higher levels in admitted HF patients compared to outpatient HF (9.37 vs. 6.62 pg/mL, p < 0.001) and control groups (9.37 vs. 4.69 pg/mL, p < 0.001). Also, mean salivary BNP levels were higher in admitted patients with HF (6.50 ng/L, p < 0.001); and outpatient HF group (5.87 ng/L, p = 0.02) compared to the control group (5.64 ng/L).

CONCLUSIONS

Our study demonstrated that BNP could be detected in saliva and that the level is higher in HF patients, especially symptomatic ones. This means that salivary BNP may be useful in the diagnosis and follow-up for patients with HF, especially in emergency settings.

摘要

背景

频繁住院和生活质量下降是心力衰竭(HF)的主要并发症。血浆B型利钠肽(BNP)水平被认为是筛查左心室功能障碍的一种经济有效的方法。关于BNP指导治疗的研究表明,可降低HF患者的死亡或住院率。

目的

由于唾液在采样方面比血液限制更少,本研究的目的是检验唾液BNP浓度是否可能成为慢性HF患者的一种新生物标志物。

方法

这项初步研究纳入了35例诊断为失代偿性HF的住院患者和35例到心脏病科进行检查的HF患者。对照组由25名无心脏疾病史的人组成。收集了所有参与者的唾液和血浆样本。

结果

发现住院HF患者的平均血浆NT-proBNP水平高于门诊HF患者(9.37对6.62 pg/mL,p<0.001)和对照组(9.37对4.69 pg/mL,p<0.001)。此外,与对照组(5.64 ng/L)相比,住院HF患者(6.50 ng/L,p<0.001)和门诊HF组(5.87 ng/L,p=0.02)的平均唾液BNP水平也更高。

结论

我们的研究表明,唾液中可检测到BNP,且HF患者,尤其是有症状的患者,其水平更高。这意味着唾液BNP可能对HF患者的诊断和随访有用,尤其是在急诊情况下。

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