脑钠肽对肺动脉高压患者的预后价值

2022-05-14 网络网络

在肺动脉高压（PAH）指南中，NT-proBNP(N末端脑利钠肽前体）水平被作为PAH评估的风险之一。但目前缺乏NT-proBNP评估PAH预后的价值。

肺动脉高压是一种相对罕见的心肺血管疾病，普通人群中发病率约为1%，但在超过65岁的人群中发病率升高至10%，其中约80%患者来自发展中国家。尽管发病率相对较低，但它却是一种高危疾病。常见症状包括活动后气促、疲乏、心绞痛等。随着肺动脉压力升高，患者心脏负荷会持续加重，最终导致右心室肥大、衰竭，甚至死亡。有流行病学资料显示，特发性及遗传性肺动脉高压患者在经过常规治疗后，5年生存率仅为20.8%。已在肺动脉高压 (PAH) 患者的风险分层中研究了多种生物标志物。(NT-pro) BNP是来自利钠肽组的激素原片段。这项系统评价和荟萃分析是第一个研究 (NT-pro)BNP 在 PAH 患者中的预后价值的研究。

BNP/NT-proBNP知多少- 快资讯

研究方法：

使用 MEDLINE、Embase、Web of Science、Cochrane 图书馆和 Google 学者进行了系统的文献检索，以确定关于 PAH 基线 (NT-pro)BNP 水平预后价值的研究。包括报告终点死亡率或肺移植的风险比 (HR) 的研究。进行随机效应荟萃分析以计算诊断时 (NT-pro)BNP 水平的汇总 HR。考虑到应用于 (NT-pro)BNP 的不同转换，HR 计算为加权平均 (NT-pro)BNP 水平的两倍差异 247 pmol/L -pro)BNP 测量。

研究结果：

共纳入 16 项研究，代表 6999 名患者（平均年龄 45.2-65.0 岁，97.3% PAH）。总体而言，1460 名患者在 1-10 年的平均随访期内达到了终点。九项研究报告了基于临界值的 HR。根据未调整的 HR 分别为 2.75（95%-CI：1.86-4.07）和 3.87（95%CI 2.69-5.57），NT-proBNP 和 BNP 升高的死亡风险均增加。六项研究持续报道了 (NT-pro)BNP 的 HR。加权平均 NT-proBNP 的两倍差异导致死亡风险增加，合并 HR 为 1.17（95%-CI：1.03-1.32）。

研究结论：

(NT-pro)BNP 水平升高与 PAH 患者死亡风险显着增加相关。

参考文献：

Hendriks PM, van de Groep LD, Veen KM, van Thor MCJ, Meertens S, Boersma E, Boomars KA, Post MC, van den Bosch AE. Prognostic value of brain natriuretic peptides in patients with pulmonary arterial hypertension: a systematic review and meta-analysis. Am Heart J. 2022 May 6:S0002-8703(22)00093-X. doi: 10.1016/j.ahj.2022.05.006. Epub ahead of print. PMID: 35533723.

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2023-04-17 jklm09

#动脉高压#

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2023-02-04 naiwu77

#肺动脉高压患者#

41 0
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2022-11-13 by2017

#脑钠肽#

29 0
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2022-05-21 ms6000001791212108

学习了

37 0
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2022-05-14 ms5000000644045955

不错，学习了，

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[GetPortalCommentsPageByObjectIdResponse(id=1925598, encodeId=967e192559842, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33354, encryptionId=26d633354c9, topicName=动脉高压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Mon Apr 17 10:57:11 CST 2023, time=2023-04-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808665, encodeId=228918086653d, content=<a href='/topic/show?id=eade820e7c0' target=_blank style='color:#2F92EE;'>#肺动脉高压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82077, encryptionId=eade820e7c0, topicName=肺动脉高压患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5b0e350, createdName=naiwu77, createdTime=Sat Feb 04 13:57:11 CST 2023, time=2023-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1654243, encodeId=708a16542430e, content=<a href='/topic/show?id=9ee8851666c' target=_blank style='color:#2F92EE;'>#脑钠肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85166, encryptionId=9ee8851666c, topicName=脑钠肽)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad2e24479777, createdName=by2017, createdTime=Sun Nov 13 07:57:11 CST 2022, time=2022-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1221376, encodeId=d8a812213e63d, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Sat May 21 12:17:50 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1219590, encodeId=b5a512195904c, content=不错，学习了，, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=1, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfa6526517, createdName=ms5000000644045955, createdTime=Sat May 14 15:01:45 CST 2022, time=2022-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385269, encodeId=581f13852696a, content=<a href='/topic/show?id=dc121001e22d' target=_blank style='color:#2F92EE;'>#预后价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100172, encryptionId=dc121001e22d, topicName=预后价值)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=70fe497, createdName=paperyu, createdTime=Thu May 12 16:57:11 CST 2022, time=2022-05-12, status=1, ipAttribution=)]
2022-05-12 paperyu

#预后价值#

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