N端脑利钠肽.pptVIP

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N端脑利钠肽ppt课件

BNP 和NT-proBNP   BNP&NT-proBNP NT- proBNP 无生理活性 血液半衰期较长(120min) 血浆和血清稳定性好 清除:肾脏 肾病病人水平相对高 BNP的1-10倍 BNP 有生理作用 血液半衰期短(22min) 血浆和血清稳定性差 清除:C受体、少数肾脏及中性内切酶 受肾功能影响小 Clinical examination, ECG, Chest X-ray Echocardiography BNP的临床应用注意事项(一) BNP的临床应用注意事项(二) 以往的研究发现经皮冠状动脉腔内成形术后血浆BNP会出现一过性升高,术中球囊扩张暂时性阻断了冠脉血流,这提示短暂心肌缺血引起BNP水平升高。 While the use of BNP for screening in the general population is not currently warranted, targeted screening of individuals at high risk of developing left ventricular systolic dysfunction would lead to more economical use of more expensive cardiac imaging procedures such as echocardiography or ultrasound. Many studies have shown that fewer than 30% of symptomatic patients referred for echocardiography turned out to have heart failure. A reliable rule-out test for CHF, with an Negative Predicative Value (NPV) of 98% or better, when used on the above population could eliminate unnecessary testing in ~68% of the symptomatic population. Additionally, a number of other utilities can be envisioned wherein BNP could be used to predict outcome, progression or response to therapy of disorders characterized by impaired cardiac function. BNP is a very active research topic today. There is no doubt that future studies will focus much time on these other potential uses of BNP. BNP has also been shown to be a useful prognostic indicator. BNP values increase as CHF progresses in severity. Increasing BNP values also correlate with the NYHA Classes and left ventricular ejection fraction. These are discussed in greater detail in slides 9-11. Since BNP appears to be the most powerful neurohormonal predictor of left ventricular function, a new area of clinical research is supporting the use of BNP in selecting patients for specific drug therapy. Studies are also being conducted to provide guidance to physicians in determining the proper dosage of these various drugs. 其主要机制如下:第一,早期心肌细胞缺血坏死已经诱发心室功能不全,虽然在24小时内尚未引起血流动力学异常,但已使心室壁张力增加,从而诱发了B

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