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难易与价值的权衡点浅谈回顾性临床研究回顾性病例对照研究标题前言方法研究设计病例介绍随访与数据收集结果总结讨论讨论点文献学习Background:ThisstudyaimedtoshowwhethercirculatingBMPslevelsareassociatedwithincreasedriskofmortalityinPAHpatients.Methods:Atotalof156PAHpatientsincluding43HPAHand113IPAHdiagnosedbygenescreeningwereenrolledinthestudy.CirculatingBMPsweremeasuredbyELISAinplasmasamplesfromHPAH(n=43),IPAH(n=113)andcontrols(n=51).Clinicalcharacteristicsatbaselineandlong-termsurvivalwerecomparedaccordingtothedifferentBMPslevels.Results:HPAHpatientshadsignificantlyhigherBMP7concentrationsthanIPAHandcontrols(20.1(9.4,55.2)vs.6.5(3.5,11.7)and2.5(0.9,6.6)pg/ml,respectively;P<0.001).ElevatedplasmaBMP7wereassociatedwithahigherriskofmortalityafteradjustmentforsex,6-minutewalkdistance,meanrightatrialpressure,meanpulmonaryarterialpressure,pulmonaryvascularresistance,andcardiacoutput(HR=1.904,95%CI1.021-3.551;P=0.043).IPAHpatientswithaBMP7levelmorethan7.85pg/mlhadahigherriskofmortalitythanthosewithalowBMP7concentration(P=0.042,logranktest).Conclusions:LevelsofcirculatingBMP7correlatewithmortalityinPAH,andmaybeapredictorofdiseaseinHPAHandIPAHpatients.研究背景研究背景1,BMPR2expressionisreportedtobegreatlyreducedinpatientswithheritablepulmonaryarterialhypertension2,BMP2,4and7havebeenshowntobethemostimportantligandsforBMPR2signalinginPulmonaryvesselsMethodsStudyDesignandPatientPopulation纳入排除标准伦理问题：知情同意书，伦理协会批文随访HemodynamicMeasurementsand6-MinuteWalkDistance(6MWD)TestMeasurementofPlasmaBMPsConcentrationsStatisticalAnalysis
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