血浆脑钠肽水平在各期慢性肾脏病患者中的变化及与心功能关系的研究  

Changes in Plasma BNP and Its Correlation with Cardio Function in Patients with Predialysis Chronic Kidney Diseases

作　　者：李国刚[1] 刘惠兰[1] 薛菲[1] 谭延国[2] 

机构地区：[1]首都医科大学附属复兴医院肾内科 [2]首都医科大学附属复兴医院检验科

出　　处：《首都医科大学学报》2008年第4期497-500,共4页Journal of Capital Medical University

基　　金：北京市西城区优秀人才培养专项基金(2006D014)资助项目~~

摘　　要：目的观察慢性肾脏病(CKD)不同时期血浆脑钠肽水平的变化,评价其对CKD患者高血容量负荷及心功能不全的诊断价值。方法根据肾小球滤过率(eGFR)将152例CKD患者分为4组,CKD-Ⅰ、Ⅱ期组;CKD-Ⅲ期组;CKD-Ⅳ期组;CKD-Ⅴ期组;同时设健康对照组32例。结果1)CKD各组血浆BNP水平均较健康对照组增高,且随eGFR减少而逐渐增高,CKD-Ⅰ、Ⅱ期以上各组与健康对照组差异有统计学意义(P<0.01)。CKD各组之间差异均有统计学意义(P<0.05);2)多元逐步回归分析显示,血浆BNP水平与左心室射血分数(LVEF)呈负相关(P<0.05),与体表面积矫正后下腔静脉宽度(VCD)呈正相关(P<0.05);与左心室舒张末期内径(LVDd)、左心室收缩期内径(LVDs)呈正相关(P<0.05);3)CKD的152例患者中,LVEF<50%者,血浆BNP显著高于LVEF>50%者。结论CKD患者血浆BNP水平随着肾功能的减退逐渐增高,是左心功能及血容量负荷的敏感指标。Objective In order to assess the diagnostic value of BNP for high blood-volume and cardiac function, we detect the changes of plasma brain natriuretic peptide（BNP） in patients with predialysis chronic kidney diseases（CKD）. Methods Plasma BNP concentrations were measured in 152 CKD patients and 32 healthy control subjects. The CKD patients were divided into four groups according to the glomerular filtration rate（GFR） by Cockcroft＇ s formula： CKD- Ⅰ and Ⅱ ; CKD-Ⅲ, CKD-Ⅳ, and CKD-Ⅴ groups. Echocardiographic examinations were performed to determine the cardiac structure and function. The inferior vena caval diameter were measured. Results Median plasma BNP concentrations increased with declining estimated GFR in CKD Groups（P 〈0.05） ; Spearman correlation showed that the BNP level was positively correlated with LVDd, LVDs and the width of postcava, but negatively correlated with LVEF. Conclusion BNP is a sensitive marker for monitoring the condition of cardiac function in CKD patients.

关 键 词：脑钠肽 慢性肾脏病 高血容量 慢性心功能不全 

分 类 号：R692[医药卫生—泌尿科学]