维持性血液透析患者N-末端脑钠肽前体与心血管事件的临床研究  

Clinical Research of Relationship between N-terminal Pro-Brain Natriuretic Peptide Levels and Cardiovascular Events in Maintenance Hemodialysis Patients

作　　者：盛晓华[1] 汪年松[1] 高许萍[1] 简桂花[1] 张晓光[1] 崔勇平[1] 俞岗[1] 

机构地区：[1]上海交通大学医学院附属第六人民医院肾内科,上海200233

出　　处：《中国中西医结合肾病杂志》2009年第6期509-512,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市医苑新星基金资助项目(No.02xx46)

摘　　要：目的:探讨N-末端脑钠肽前体(NT-proBNP)在评估维持性血液透析患者心血管事件发生中的意义。方法:选取我院维持性血液透析患者92例,应用电化学发光法检测NT-proBNP,同时应用彩色多普勒超声心动图测定患者的左室舒张末内径(LIDd)、左室后壁厚度(LVPWT)、舒张末室间隔厚度(IVST)、左室射血分数(LVEF),并记录患者的一般情况及临床各项指标并随访观察半年,记录随访期间血透患者发生的心血管事件。结果:所有血透患者的NT-proBNP水平均高于正常值,在半年随访期间共发生心血管事件17例(其中死亡4例)。事件组NT-proBNP中位数为24732ng/L,非事件组NT-proBNP中位数为2329ng/L,两组差异有统计学意义(P<0.01)。Logistic回归分析证实NT-proBNP是血透患者心血管事件发生的独立危险因子。结论:NT-proBNP作为一项有用的生物学标记物可以预测维持性血透患者心血管事件的发生。Objective：To investigate the relationship between N - terminal pro- brain natriuretic peptide （NT- proBNP） levels and cardiovascular events in maintenance hemodialysis patients. Methods： A prospective cohort study was conducted in 92 maintenance hemodialysis patients. Serum NT-proBNP was measured using electrochemiluminescence immunoassay, together with echocardiography and dialysis indices. Each patient was followed up for six months. Results： Concentrations of NT- proBNP increased in all of the patients. During the follow up period, 17 patients underwent a cardiovascular event （4 patients died）. The median NT- proBNP level in event group was significantly higher than in non - event group （ 24 732 ng/L vs. 2 329 ng/L, P 〈 0.01 ）. NT - proBNP was revealed to be the strong independent predictor of cardiovascular events by multiple logistic regression analysis. Conclusion： Plasma NT- proBNP is a useful biochemical marker to predict the ocurrence of cardiovascular event in maintenance hemodialysis patients.

关 键 词：维持性血液透析 N-末端脑钠肽前体 心血管事件 

分 类 号：R459.5[医药卫生—治疗学] R544.1[医药卫生—临床医学]