NT-ProBNP水平是是晚期心力衰竭最好的预后指标

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NT-ProBNP Level Best Prognostic Indicator for Advanced Heart Failure
NT-ProBNP水平是是晚期心力衰竭最好的预后指标
NEW YORK (Reuters Health) Jan 29 - New research indicates that the plasma level of NT-proBNP is a better prognostic indictor than the glomerular filtration rate (GFR) estimated with standard equations in patients with advanced heart failure.
纽约（路透健康）1月19日-新的研究表明根据标准方程的计算，血浆N末端前脑利钠肽（NT-proBNP）与肾小球滤过率（GFR）相比是晚期心力衰竭患者更好的预后指标。
As reported in the European Heart Journal for December, Dr. Roy S. Gardner, from the Royal Infirmary in Glasgow, UK, and colleagues assessed NT-proBNP levels and GFR (estimated with the modification of diet in renal disease equations) in 182 patients with advanced heart failure who were being considered for cardiac transplantation. The median follow-up period was 642 days.
据《欧洲心脏杂志》12月刊的报道，英国格拉斯哥皇家医院的Dr. Roy S. Gardner及其同事收集了182例考虑行心脏移植的晚期心力衰竭患者，估算其NT-proBNP水平和GFR（通过校正饮食的肾病方程来计算）。中位随访时间是642天。
During follow-up, 40 patients died, 4 required urgent cardiac transplantation, and another 29 underwent non-urgent transplantation.
随访期间，40例患者死亡，4例需进行紧急心脏移植，另有29例接受了择期移植。
On univariate analysis, GFR predicted all-cause mortality. On multivariate analysis, however, only the NT-proBNP level was a significant independent predictor of all-cause mortality or the combined endpoint of all-cause mortality or urgent transplantation.
单变量分析发现GFR可以预测全因死亡。然而，多变量分析发现只有NT-proBNP水平是全因死亡或全因死亡与紧急移植联合终点的显著独立预测因素。
The current study \"represents an important step forward regarding the utility of NT-proBNP testing in patients with impaired renal function,\" Dr. James L. Januzzi, from Massachusetts General Hospital in Boston, and colleagues write in a related editorial.
波士顿马萨诸塞州医院的Dr. James L. Januzzi及其同事在相关评述中写道，该研究“代表了对肾功能不全患者应用NT-proBNP检测的重要进步”。
The findings indicate that NT-proBNP \"is strongly prognostic for death and/or urgent cardiac transplantation even in the presence of renal impairment,\" they add.
他们同时指出这些发现表明NT-proBNP“对患者死亡和（或）紧急心脏移植有很强的预测价值，甚至伴肾功能不全时也是如此”。


讨论
心衰近年忽然成了研究热点。
众多心脏病晚期基本都发展成了心衰，特别是随着医疗水平进步，很多以前救不了的患者现在都能用各种治疗延长生命，只是结局很难逆转，估计拖到最后就都成心衰了。这样看来心衰成为研究热点也是理所当然。
BNP前体的预后价值能够明确的确让人欣慰，但利用BNP治疗的效果仍在广泛研究中，期待能给心衰治疗带来一线曙光。