透析患者心房利尿肽与左心室肥厚、血容量相关关系的研究  

Relationship between atrial natriuretic peptide(ANP) and left ventricular hypertrophy,blood volume in dialysis patients

作　　者：吴杏[1] 叶任高[1] 陈国伟[1] 汪涛[1] 彭文兴[1] 余学清[1] 

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《中国心血管杂志》2006年第2期123-126,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的了解透析患者心房利尿肽(ANP)与左心室肥厚(LVH)、血容量(ECV)的相关关系。方法分别测量我院73例血液透析(HD)、46例腹膜透析(CAPD)、18例肾衰竭未行透析患者及16例健康人的超声心动图,以了解LVH的发病率,用Xitron 4200生物阻抗分析仪(BIA)分别测量研究对象的ECV,并予干体重标准化(nECV),检查血ANP水平,行相关关系研究。结果与对照组相比,HD、CAPD、慢性肾衰竭患者LVH的发生率明显增高,以透析患者升高明显,差异有显著性(P<0.001)。CAPD组、HD组的ANP较慢性肾衰竭组和对照组明显增高,慢性肾衰竭组的ANP也较对照组明显升高(P<0.05)。HD、CAPD和慢性肾衰竭患者的ECV均明显升高(P<0.001),以HD、CAPD两组ECV升高最为明显。同时LVH与nECV、ANP均呈显著相关关系(r=0.54,P<0.05;r=0.844,P<0.001)。结论透析患者ANP水平较高,与ECV和LVH的发生密切相关。提示ANP水平可预示透析患者LVH的发生率。Objective To investigate risk lactors of LVH and its relationship with blood volume of dialysis patient in our hospital through cross-sectional study. Methods 73 hemodialysis patients, 46 CAPD patients and 18 chronic renal insufficiency patients {CRF） were included in this study, 16 healthy adults were served as the control group. The extracellular fluid volume （ECV） was measured using a Xitron-4200 hioimpedance assessment device and was normalized by patients＇ dry weights which were clinically determined （ nECV）. The presence of LVH was determined by ultrasonic cardiography （UCG）, atrial natriuretic peptide（ANP） were tested by radioimmunoassay Results The incidence of LVH was 56%, 68%, 39%, and 0 for the CAPD patients, hemodialysis patients, chronic renal insufficiency patients and normal control, respectively. The nECV in uremic patients were much higher than the control group（ P 〈 0. 001）, especially in dialysis patients. The ANP was significantly higher in dialysis patients. There were significant correlations between LVH and nECV , ANP（ P〈0.05 ）. Conclusion The ANP level in dialysis patients is higher, the strong correlation with nECV and LVH suggest that ANP may have dignostic value in the incidence of LVH in uremic patients.

关 键 词：透析 心房利尿肽 左心室肥厚 血容量 

分 类 号：R692.5[医药卫生—泌尿科学]