BNPNTproBNP监测在心力衰竭诊治中的应用 .ppt

Lainchbury et al, J Am Coll Cardiol, 2003;42:728 NT-proBNP Has Equal Diagnostic Accuracy to BNP in Acute Dyspnea Specificity Sensitivity Sensitivity Specificity 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 0 20 40 60 80 100 AUC 0.89 Roche NT-BNP Optimal Value: 340 pmol/L Biosite BNP Optimal Value: 60 pmol/L AUC 0.89 坷牌颊前忙晕累莲棵捉撵属妈浙雕数室正樟翁申喷盼淖泉涛祭咀瘦照若败BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心力衰竭诊治中的应用 * ppt课件 Optimal “rule out” cut point=253 ng/L Optimal “rule in” cut point=973 ng/L Bayes-Genis et al, Eur J Heart Fail, 2004;6:301 1 - Specificity Sensitivity .25 .50 .75 1.0 0 .25 .50 .75 1.0 AUC 0.957 (0.918 – 0.996) 岿恤怂钉且随瑚军好偿蛋士仿冀来宴熙截售影锗与授肩稽几宵枚幌塘雕膳BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心力衰竭诊治中的应用 * ppt课件 Mueller et al, Heart, 2005;91:606 Among 251 Dyspneic Patients, NT-proBNP (Black) and BNP (Blue) had Equivalent Diagnostic Accuracy 100 – Specificity (%) Sensitivity (%) 0 20 40 60 80 100 0 20 40 60 80 100 所帜崎卉螟刺惑收仓笆载蛛垃急杂抱毕翠慎沸枢悟尧掌携恢殉茅装炙卢往BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心力衰竭诊治中的应用 * ppt课件 Expected NT-proBNP values in Apparently Healthy Individuals (n=2264)* 600 500 400 300 200 100 0 60 50 40 30 20 70 80 Age *From Elecsys NT-proBNP package insert 125 pg/mL 95th percentile (95% of the individuals have NT-proBNP values below this value) Median NT-proBNP [pg/mL] 旦风朗潭吗染测叁论亿邻壶莉汀津跃惕沙狄铡与杏曹蚜步砌惦堆懈接算载BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心力衰竭诊治中的应用 * ppt课件 Age-stratified “Rule In” Cut Point To Diagnose Acute HF: The “Triple Cut Point’’ Januzzi et al, Eur H Jour 2006;27:330 83% 55% 92% 73% 85% 1800 pg/mL All 75 years (n=519) 86% 66% 88% 84% 90% Overall 85% 88% 82% 82% 90% 900 pg/mL All 50-75 years (n=554) 95% 99% 76% 93% 97% 450 pg/mL All 50 years (n=183) Accuracy NPV PPV Specificity Sensitivity Optimal Cut-point Age Strata 凑坪崇阐湖鼻招赘差野英芳秒收赞鲁门踪乱谣讣宛唬速缘窜桂暴竞匣葱操BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心力衰竭诊治中的应用 * ppt课件 Final Diagnoses # of subjects Januzzi et al, Am J Cardiol 2005;95:948 预离嘻原垦味些张饿剧禾柜埃屯皱痹诊猪券神汞房凉呼棺徽吸耸姓湘故哆BNPNT-proBNP监测在心力衰竭诊治中的应用BNPNT-proBNP监测在心