血浆N-末端脑利钠肽在慢性肾脏病非透析患者合并心力衰竭中的临床意义  

The Clinical Significance of Plasma N-Terminal Brain Natriuretic Peptide Level in Chronic Kidney Disease Patients Accompanied by Heart Failure without Dialysis

作　　者：郭旭武[1] 陈楚鹏[1] 王奕忠[1] 王良玉[1] 

机构地区：[1]中山大学附属汕头医院,广东汕头515031

出　　处：《河北医学》2009年第9期1015-1018,共4页Hebei Medicine

摘　　要：目的:探讨血浆N-末端脑利钠肽(NT-proBNP)与慢性肾脏病(CKD)非透析患者心功能不全的关系。方法:电化学发光法测定59例CKD非透析合并慢性心力衰竭(CHF)患者与正常对照组10例患者的血浆NT-proBNP水平,心脏超声测定心脏左室射血分数(LVEF),全自动生化仪检测血肌酐、尿素氮等。结果:①心衰患者血浆NT-proBNP水平明显高于非心衰组患者[(5927.8±9628.6比80.3±46.4)ng/L,P<0.001];②如以120 ng/L为正常参考值,NT-proBNP诊断心衰的敏感性93.2%(55/59),特异性90.0%(9/10);③心衰患者NT-proBNP水平与LVEF呈负相关(r=-0.407,P<0.01),同时,心衰患者NT-proBNP水平与GFR也呈负相关(r=-0.541,P<0.001);④多元回归分析显示LVEF和GFR均是影响NT-proBNP水平的独立因素。结论:CKD非透析患者NT-proBNP水平与心功能、肾功能相关,NT-proBNP水平可作为一项评价CKD非透析患者心功能的指标。Objective： To investigate relationship between the plasma N -Terminal brain natriuretic peptide （ NT - proBNP） level and chronic heart failure （CHF） in chronic kidney disease （CKD） patients without dialysis. Method： The electroehemiluminescence assay and the complete automatic biochemistry analyzer was respectively used to dectect NT - proBNP level and creatinine, urea nitrogen level in 59 cases chronic kidney disease （CKD） patients without dialysis , and echoeardiograghy was used to measure the left ventrieular ejection fraction （LVEF） in the patients . Result： （1）The plasma NT - proBNP level in patients with heart failure was significantly higher than that in patients with non - heart failure group [ （5927.8 ± 9628.6 vs 80.3 ± 46.4 ） ng/L, P 〈 0 . 001 ] ; （2） The detection 120 ng/L of NT - proBNP as normal reference value could be used to diagnose CHF with sensitivity of 93.2% （ 55/59 ） and specificity 90.0% （ 9 / 10 ） ; （3） There was negatively correlated （ r = - 0 . 407, P 〈0.01 ） between NT - proBNP levels and LVEF, and there was negatively correlated （ r = -0.541 ,P 〈0.001 ） between NT - proBNP levels and GFR （4） The multiple regression analysis showed that LVEF and GFR are the independent factors to NT- proBNP level . Conclusion： There was significantly correlated （ r = - 0 . 40.7, P 〈 0. O1 ） between NT - proBNP levels and heart function and kidney function in CKD patients without diStal-y-sis , NT -proBNP levels can be used to evaluate the CKD patients without dialysis as an indicators of cardiac function.

关 键 词：脑利钠肽 心力衰竭 肾透析 慢性肾脏病 

分 类 号：R692[医药卫生—泌尿科学]