B型利鈉肽對急性肺栓塞預后預測價值的Meta分析_《中國循證醫學雜志》

作者：

檀旦 ,  趙玉虹 , 黃亞明

中國醫科大學信息管理與信息系統（醫學）系（沈陽?110001）;

關鍵詞：

利鈉肽腦肺栓塞 Meta分析

DOI：

10.7507/1672-2531.20110012

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　探討B型利鈉肽（B-type natriuretic peptide，BNP）對急性肺栓塞（acute pulmonary embolism，APE）患者短期全死因死亡的預測價值。
方法　計算機檢索PubMed、EMbase、Cochrane圖書館臨床對照試驗資料庫、CBM網絡版和CNKI等數據庫，檢索時間均從建庫至2010年3月，收集BNP和N-終端前BNP（N-terminal pro-B-type natriuretic peptide，NT-proBNP）水平升高對APE患者預后影響的隊列研究，對符合納入標準的臨床研究進行質量評價和資料提取后，采用RevMan 5.0和MetaDisc軟件進行Meta分析。
結果　共納入16項研究，合計1 126例患者。9個研究報道了BNP水平，7個研究報道了NT-proBNP水平，各組間異質性較小（P=0.94，I2=0；P=0.99，I2=0），且無臨床異質性，故將BNP或NT-proBNP升高視為同一結果。Meta分析結果顯示：BNP或NT-proBNP水平升高對于短期全死因死亡預測價值的SEN合并為0.89，SPE合并為0.52，+LR合并為1.87，–LR合并為0.20，PPV為0.16，NPV為0.98，SROC 曲線下面積為 0.830 5，SE（AUC）=0.033 5。
結論　BNP水平升高可以幫助鑒別死亡率高的急性肺栓塞患者，而BNP水平正常的患者陰性預測值高則有助于醫生識別出那些不良事件發生可能性較低的患者，以便有選擇性地進行患者隨訪。

引用本文： 檀旦,趙玉虹,黃亞明. B型利鈉肽對急性肺栓塞預后預測價值的Meta分析. 中國循證醫學雜志, 2011, 11(1): 64-69. doi: 10.7507/1672-2531.20110012 復制

1.	李德新, 賈慧敏, 王清濤. BNP的測定和臨床應用的研究進展. 現代生物醫學進展, 2006, 6(10): 139-142.
2.	Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature, 1988, 332(6159): 78-81.
3.	蘇哲坦. 腦鈉利尿肽臨床應用的進展及其爭論. 海南醫學院學報, 2005, 11(5): 438-441.
4.	谷國強. 急性肺栓塞患者危險分層的生物學指標. 國際心血管病雜志, 2006, 33(2): 110-113.
5.	Cavallazzi R, Nair A, Vasu T, et al. Natriuretic peptides in acute pulmonary embolism: a systematic review. Intensive Care Med, 2008, 34(12): 2147-56.
6.	Coutance G, Le Page O, Lo T, et al. Prognostic value of brain natriuretic peptide in acute pulmonary embolism. Crit Care, 2008, 12(4): R109. Epub 2008 Aug 22.
7.	Kucher N, Printzen G, Goldhaber SZ. Prognostic role of brain natriuretic peptide in acute pulmonary embolism. Circulation, 2003, 107: 2545-2547.
8.	Ten Wolde M, Tulevski II, Mulder JW. Brain natriuretic peptide as a predictor of adverse outcome in patients with pulmonary embolism. Circulation, 2003, 107: 2082-2084.
9.	Pieralli F, Olivotto I, Vanni S, et al. Usefulness of bedside testing for brain natriuretic peptide to identify right ventricular dysfunction and outcome in normotensive patients with acute pulmonary embolism. Am J Cardiol, 2006, 97: 1386-1390.
10.	Krüger S, Graf J, Merx MW, et al. Brain natriuretic peptide predicts right heart failure in patients with acute pulmonary embolism. Am Heart J, 2004, 147: 60-65.
11.	Tulevski II, ten Wolde M, van Veldhuisen DJ, et al. Combined utility of brain natriuretic peptide and cardiac troponin T may improve rapid triage and risk stratification in normotensive patients with pulmonary embolism. Int J Cardiol, 2007, 116: 161-166.
12.	Logeart D, Lecuyer L, Thabut G, et al. Biomarker-based strategy for screening right ventricular dysfunction in patients with nonmassive pulmonary embolism. Intensive Care Med, 2007, 33: 286-292.
13.	Ray P, Maziere F, Medimagh S, et al. Evaluation of B-type natriuretic peptide to predict complicated pulmonary embolism in patients aged 65 years and older: brief report. Am J Emerg Med, 2006, 24: 603-607.
14.	杜林林, 邱俏檬, 盧中秋, 等. BNP在急性肺栓塞中的變化及意義. 醫學研究雜志, 2007, 36(3): 46-48.
15.	李炳華, 王惠閣, 張金卓, 等. 腦鈉肽和肌鈣蛋白I聯合檢測對急性肺栓塞預后評估的意義. 臨床醫藥, 2007, 16(23): 54-55.
16.	Pruszczyk P, Kostrubiec M, Bochowicz A, et al. N-terminal pro-brain natriuretic peptide in patients with acute pulmonary embolism. Eur Respir J, 2003, 22: 649-653.
17.	Kucher N, Printzen G, Doernhoefer T, et al. Low pro-brain natriuretic peptide levels predict benign clinical outcome in acute pulmonary embolism. Circulation, 2003, 107: 1576-1578.
18.	Kostrubiec M, Pruszczyk P, Bochowicz A, et al. Biomarker-based risk assessment model in acute pulmonary embolism. Eur Heart J, 2005, 26: 2166-2172.
19.	Binder L, Pieske B, Olschewski M, et al. N-terminal pro-brain natriuretic peptide or troponin testing followed by echocardiography for risk stratification of acute pulmonary embolism. Circulation, 2005, 112: 1573-1579.
20.	Maziere F, Birolleau S, Medimagh S, et al. Comparison of troponin I and N-terminal-pro Btype natriuretic peptide for risk stratification in patients with pulmonary embolism. Eur J Emerg Med, 2007, 14: 207-211.
21.	Alonso-Martínez JL, Urbieta-Echezarreta M, Anniccherico-Sánchez FJ, et al. N-Terminal Pro-B-Type Natriuretic Peptide Predicts the Burden of Pulmonary Embolism. Am J Med Sci, 2009, 337(2): 88-92.
22.	Kostrubiec M, Pruszczyk P, Kaczynska A, et al. Persistent NT-proBNP elevation in acute pulmonary embolism predicts early death. Clin Chim Acta, 2007, 382(1-2): 124-128.
23.	Becattini C, Cristina Vedovati M, et al. Prognostic value of troponins in acute pulmonary embolism. Circulation, 2007, 116: 427-433.

1. 李德新, 賈慧敏, 王清濤. BNP的測定和臨床應用的研究進展. 現代生物醫學進展, 2006, 6(10): 139-142.
2. Sudoh T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature, 1988, 332(6159): 78-81.
3. 蘇哲坦. 腦鈉利尿肽臨床應用的進展及其爭論. 海南醫學院學報, 2005, 11(5): 438-441.
4. 谷國強. 急性肺栓塞患者危險分層的生物學指標. 國際心血管病雜志, 2006, 33(2): 110-113.
5. Cavallazzi R, Nair A, Vasu T, et al. Natriuretic peptides in acute pulmonary embolism: a systematic review. Intensive Care Med, 2008, 34(12): 2147-56.
6. Coutance G, Le Page O, Lo T, et al. Prognostic value of brain natriuretic peptide in acute pulmonary embolism. Crit Care, 2008, 12(4): R109. Epub 2008 Aug 22.
7. Kucher N, Printzen G, Goldhaber SZ. Prognostic role of brain natriuretic peptide in acute pulmonary embolism. Circulation, 2003, 107: 2545-2547.
8. Ten Wolde M, Tulevski II, Mulder JW. Brain natriuretic peptide as a predictor of adverse outcome in patients with pulmonary embolism. Circulation, 2003, 107: 2082-2084.
9. Pieralli F, Olivotto I, Vanni S, et al. Usefulness of bedside testing for brain natriuretic peptide to identify right ventricular dysfunction and outcome in normotensive patients with acute pulmonary embolism. Am J Cardiol, 2006, 97: 1386-1390.
10. Krüger S, Graf J, Merx MW, et al. Brain natriuretic peptide predicts right heart failure in patients with acute pulmonary embolism. Am Heart J, 2004, 147: 60-65.
11. Tulevski II, ten Wolde M, van Veldhuisen DJ, et al. Combined utility of brain natriuretic peptide and cardiac troponin T may improve rapid triage and risk stratification in normotensive patients with pulmonary embolism. Int J Cardiol, 2007, 116: 161-166.
12. Logeart D, Lecuyer L, Thabut G, et al. Biomarker-based strategy for screening right ventricular dysfunction in patients with nonmassive pulmonary embolism. Intensive Care Med, 2007, 33: 286-292.
13. Ray P, Maziere F, Medimagh S, et al. Evaluation of B-type natriuretic peptide to predict complicated pulmonary embolism in patients aged 65 years and older: brief report. Am J Emerg Med, 2006, 24: 603-607.
14. 杜林林, 邱俏檬, 盧中秋, 等. BNP在急性肺栓塞中的變化及意義. 醫學研究雜志, 2007, 36(3): 46-48.
15. 李炳華, 王惠閣, 張金卓, 等. 腦鈉肽和肌鈣蛋白I聯合檢測對急性肺栓塞預后評估的意義. 臨床醫藥, 2007, 16(23): 54-55.
16. Pruszczyk P, Kostrubiec M, Bochowicz A, et al. N-terminal pro-brain natriuretic peptide in patients with acute pulmonary embolism. Eur Respir J, 2003, 22: 649-653.
17. Kucher N, Printzen G, Doernhoefer T, et al. Low pro-brain natriuretic peptide levels predict benign clinical outcome in acute pulmonary embolism. Circulation, 2003, 107: 1576-1578.
18. Kostrubiec M, Pruszczyk P, Bochowicz A, et al. Biomarker-based risk assessment model in acute pulmonary embolism. Eur Heart J, 2005, 26: 2166-2172.
19. Binder L, Pieske B, Olschewski M, et al. N-terminal pro-brain natriuretic peptide or troponin testing followed by echocardiography for risk stratification of acute pulmonary embolism. Circulation, 2005, 112: 1573-1579.
20. Maziere F, Birolleau S, Medimagh S, et al. Comparison of troponin I and N-terminal-pro Btype natriuretic peptide for risk stratification in patients with pulmonary embolism. Eur J Emerg Med, 2007, 14: 207-211.
21. Alonso-Martínez JL, Urbieta-Echezarreta M, Anniccherico-Sánchez FJ, et al. N-Terminal Pro-B-Type Natriuretic Peptide Predicts the Burden of Pulmonary Embolism. Am J Med Sci, 2009, 337(2): 88-92.
22. Kostrubiec M, Pruszczyk P, Kaczynska A, et al. Persistent NT-proBNP elevation in acute pulmonary embolism predicts early death. Clin Chim Acta, 2007, 382(1-2): 124-128.
23. Becattini C, Cristina Vedovati M, et al. Prognostic value of troponins in acute pulmonary embolism. Circulation, 2007, 116: 427-433.

上一篇
丹紅注射液治療冠心病心絞痛隨機對照試驗的系統評價
下一篇
循證藥學定義和文獻的系統評價

《中國循證醫學雜志》

B型利鈉肽對急性肺栓塞預后預測價值的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

B型利鈉肽對急性肺栓塞預后預測價值的Meta分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料