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用于社区查左心室缩和心功能障碍的血性尿素:弗雷明翰心脏研究
Ramachandran S Vasan1, Emelia J Benjamin, Martin G Larson
1National Heart, Lung, and Blood Institute's Framingham Heart Study, 73 Mt Wayte Ave, Suite 2, Framingham, MA 01702, USA. vasan@fram.nhlbi.nih.gov
JAMA
|September 7, 2002
概括
血大脑性尿素 (BNP) 和N终端亲性尿素 (NT-ANP) 在查左心室缩 (LVH) 和静脉功能障碍 (LVSD) 中表现不佳. 这些天然尿素作为大众查工具在一般社区的实用性有限.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 诊断的准确性 诊断的准确性
背景情况:
- 血大脑尿性 (BNP) 已被提议作为左心室缩 (LVH) 和静脉功能障碍 (LVSD) 的查工具.
- 之前的研究受到小样本大小,选择偏差和缺乏性别特定比较的限制.
研究的目的:
- 评估 natriuretic的实用性,以社区为基础的左心室 (LV) 质量升高和LVSD的查.
- 为了比较BNP的诊断性能和男性和女性的N-终端亲性尿素 (NT-ANP).
主要方法:
- 一项基于社区的前性队列研究,对来自弗雷明汉研究的3177名参与者进行了研究.
- 接收器运行特征 (ROC) 曲线,灵敏度,特异性,预测值和概率比率为BNP和NT-ANP计算.
- 心声学作为评估LV质量和LVSD的标准标准.
主要成果:
- 对于高LV质量或LVSD的ROC曲线下的面积为≤0.75对于这两种,在男性中高于女性,在BNP和NT-ANP之间相似.
- 在高危子组中,女性的LVSD诊断性能有所改善,但男性没有.
- 高特异性极限改善了预测值,但只有不到三分之一的个体发现了增加的LV质量或LVSD.
结论:
- 在这个大型社区样本中,BNP和NT-ANP在检测高 LV 质量和LVSD方面的表现不足于最佳.
- 尿酸作为LVH和LVSD的大规模查工具的有用性有限.
- 可能需要进一步的研究来确定最佳的查策略.
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