プラズマ脳ナトリウレチンペプチドは,原発性肺高血圧の患者における予後指標として用いられる
N Nagaya1, T Nishikimi, M Uematsu
1Division of Cardiology, Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Circulation
|August 23, 2000
まとめ
高血脳ナトリウレチンペプチド (BNP) レベルは,一次性肺高血圧 (PPH) の死亡率を予測する. フォローアップ中のBNPの増加は,PPH患者の死亡リスクの増加と強く関連しています.
科学分野:
- 心臓病学 心臓病学
- 肺内科 肺内科 肺内科
- バイオマーカー バイオマーカー
背景:
- 血脳ナトリウレチンペプチド (BNP) レベルは,肺高血圧における右心室機能不全と相関しています.
- 一次性肺高血圧 (PPH) は,重要な臨床的課題を提示しています.
研究 の 目的:
- PPHと診断された患者の血BNPの予後値を評価する.
- BNPレベルがPPHにおける死亡率を予測できるかどうかを判断する.
主な方法:
- 血BNPは,診断時に60人のPPH患者および3ヶ月のフォローアップ時に53人の患者で測定されました.
- 多変量分析とカプラン・マイヤー生存曲線を用いて,予後的有意性を評価した.
- プロスタサイクリンの治療は49人の患者に投与された.
主要な成果:
- ベースラインプラズマBNPは,PPH患者における死亡率の独立した予測因子でした.
- ベースラインより高いBNP (>="150"pg/mL) を有する患者は,生存率が著しく低下した.
- 追跡期間中に生存者のBNP濃度が低下し,生存していない人のBNP濃度が上昇し,より高い追跡BNP (>= "180" pg/mL) は生存率の低下を示しています.
結論:
- 血BNP濃度の上昇は,PPH患者の死亡率の増加と強く関連しています.
- 追跡期間中の血BNPの上昇傾向は,さらに不良な予後と死亡リスクの増加を示しています.
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