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女性冠心病平板运动试验前后血浆B型脑尿肽水平的变化及临床意义

陈晖1,罗梦娇1,2   

  1. 1. 南昌大学第三附属医院
    2.
  • 收稿日期:2013-08-22 修回日期:2013-12-05 出版日期:2014-03-15 发布日期:2014-03-15
  • 通讯作者: 陈晖

Clinical significance and variation of plasma B-type natriuretic peptide levels before and after treadmill exercise test in women with coronary heart disease

  • Received:2013-08-22 Revised:2013-12-05 Published:2014-03-15 Online:2014-03-15
  • Contact: Hui Chen

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摘要： 【摘要】 目的 观察女性冠心病患者平板运动试验(TET)前后血浆B型脑尿肽水平变化(△BNP)及临床意义。方法 入选女性疑似冠心病病例61例(除外心力衰竭)，所有患者均行冠状动脉造影检查，分为正常组25例和冠心病组36例，1周内所有患者行TET，分别在TET前后测定血浆BNP水平，比较两组TET前后血浆BNP水平，比较不同冠状动脉病变程度患者TET前后△BNP水平，根据受试者工作特征曲线(ROC)下面积评价不同△BNP水平诊断冠心病的价值。结果 冠心病组TET后血浆BNP水平较试验前显著升高(P < 0.05)；不同冠状动脉病变程度患者TET前后△BNP水平存在差异，多支病变组高于单支和双支病变组(P < 0.05)，双支病变组高于单支病变组(P < 0.05)；当TET前后△BNP的水平 > 7.3 pg/ml时，诊断冠心病的敏感性为82.4%，特异性为81.5%，AUC为0.900，95%可信区间为0.796-0.962。结论 TET前后检测△BNP水平对女性冠心病诊断及评价病情具有重要临床意义。

关键词: B型脑尿肽, 平板运动试验, 女性, 冠心病, 冠状动脉造影

Abstract: [Abstract] Objective To observe clinical significance and variation of plasma B-type natriuretic peptide(△BNP) levels before and after treadmill exercise test(TET) in women with coronary heart disease． Methods Selected cases of women with suspected coronary heart disease in 61 cases(except for heart failure, blood BNP levels were normal)，all patients underwent coronary angiography，were divided into 25 cases of normal group and 36 cases of coronary heart disease group. All patients underwent TET were measured plasma BNP levels before and after the test，compared levels of plasma BNP before and after TET in both groups after one week．The levels of △BNP before and after DSE in different degree of coronary artery lesions patients were compared. The diagnostic value of the levels of △BNP in coronary heart disease was evaluated by the receiver operating characteristic curve (ROC). Results The levels of plasma BNP after TET in coronary heart disease group increased significantly(P <0.01) than before the test. The levels of △BNP before and after TET in different degree of coronary lesions patients was statistically significant difference, multivessel disease group was higher than that of single and double operation lesion group (P < 0.05), double vessel disease group was higher than that of single vessel disease group (P < 0.05). When the levels of △BNP > 7.3 pg/ml, the sensibility value and specificity value of diagnosing CHD was 82.4% and 81.5%. Area under curve(AUC) was 0.900, and 95% confidence interval was 0.796-0.962. Conclusion Detection of the levels of △BNP before and after TET in women with coronary heart disease patients with diagnosis and evaluation has important clinical significance.

Key words: B-type natriuretic peptide, treadmill exercise test, women, coronary heart disease, coronary angiography