脳ナトリウレチンペプチドが,肺栓塞患者における有害な結果の予測因子として用いられる
M ten Wolde1, I I Tulevski, J W M Mulder
1Department of Vascular Medicine, F4-138, Academic Medical Center, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands. m.tenwolde@amc.uva.nl
Circulation
|April 23, 2003
まとめ
血脳ナトリウレチンペプチド (BNP) レベルは,肺栓塞患者の致命的な結果を予測することができます. 高濃度のBNP (>21.7 pmol/L) は死亡リスク17%を示し,低濃度のBNPは死亡リスク99%を示している.
科学分野:
- 心臓病学 心臓病学
- 肺内医学 肺内医学 肺内医学
- バイオマーカーの研究
背景:
- 肺栓塞 (PE) は,抗凝固剤療法にもかかわらず,著しい死亡リスク (2-7%) を伴う.
- PEの予後マーカーを特定することは,リスクの階層化と患者管理に不可欠です.
研究 の 目的:
- 急性肺栓塞と診断された患者における致命的な結果の予測因子としてのプラズマ脳ナトリウレチンペプチド (BNP) を調査する.
- PE患者におけるベースラインのBNPレベルと臨床結果との関係を評価する.
主な方法:
- 肺栓塞の連続した110人の患者を対象とした研究.
- プレゼンテーション時の血BNP濃度の測定.
- 結末イベントとの関連を決定するために,BNP濃度テルティルの分析.
- BNPレベルに対するポジティブとネガティブな予測値の計算.
主要な成果:
- 血BNPレベル>21.7pmol/Lは,肺栓塞による死亡リスク17% (95%CI,6~33%) と関連していました.
- BNP値 <21.7 pmol/Lは,無事な結果に対して高い負の予測値 (99%; 95% CI, 93%から100%) を示した.
結論:
- 血のBNP濃度は,急性肺栓塞の患者における有害な結果の有意な予測要因として機能する.
- この研究は,血のBNPレベルと急性PEの予後を結びつける最初の証拠を提供します.
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