B型利钠肽对老年维持性血液透析患者左心功能评估的临床研究  

The study of B-type natriuretic peptide in evaluating left ventricular function of elderly hemodialysis patients

作　　者：陈学波[1] 朱水娣[1] 胡玉纹[1] 吴广宇[1] 

机构地区：[1]浙江省舟山市人民医院肾内科,316000

出　　处：《中国医师进修杂志》2009年第2期10-13,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察老年维持性血液透析（MHD）患者血浆B型利钠肽（BNP）水平与左心功能之间的关系。方法检测50例老年MHD患者（MHD组）和30例健康体检者（健康对照组）的BNP水平，以及彩色多普勒超声心动图测定的左室射血分数（LVEF）。分析BNP水平与左心功能之间的关系。结果MHD组透析前后血浆BNP中位数分别为213．5ngtL及110．2n巩，健康对照组为20．2ng／L，MHD组的BNP水平透析前后均较健康对照组显著增高（P〈0．01），且透析后较透析前显著下降（P〈0．01）。Spearman等级相关分析结果提示，MHD组的血浆BNP水平与LVEF呈负相关（r=-0．4357，P〈0．05）。LVEF〈50％者20例，透析前后血浆BNP中位数分别为386．5．g／L和232．0ng／L，LVEF-50％者30例，透析前后血浆BNP中位数分别为59．7ng／L和29．1ng／L，两组比较差异有统计学意义（P〈0．01）。结论BNP可反映左心功能的动态变化，可能有助于MHD患者的心血管疾病早期诊断和治疗。Objective To detect the relationship between plasma B-type natriuretic peptide（BNP） and left ventricular function in elderly patients with maintenance hemodialysis （MHD）. Method Plasma BNP concentration were measured in 50 MHD patients （MHD group） and 30 healthy controls （control group）. Echocardiographie examinations were performed including left ventrieular ejection fraction （LVEF）. Results The median plasma BNP level in MHD group before and after hemodialysis was 213.5 ng/L and 110.2 ng/L, and obviously higher than that in control group （20.2 ng/L） （P 〈0.01）. Spearman rank correlation showed that plasma BNP level was significantly negatively correlated with LVEF （r = -0.4357, P 〈 0.05）. The median plasma BNP level in the patients with LVEF 〈 50% before and after hemodialysis was 386.5 ng/L and 232.0 ng/L, significantly higher than that in the patients without left ventricular dysfunction （LVEF ≥ 50%） （59.7 ng/L and 29.1 ng/L） （P 〈 0.01 ）. Conclusions The level of BNP may reflect dynamic change of left ventricular function in MHD patients. It can help to diagnose and treat cardiovascular disease in MHD patients early.

关 键 词：利钠肽 脑 肾透析 心室功能 左 

分 类 号：R541.6[医药卫生—心血管疾病]