儿童维持性血液透析血浆BNP水平的变化  

Changes in plasma BNP levels in children on maintenance hemodialysis

作　　者：焦莉平[1] 樊剑峰[1] 文圆[1] 孙嫱[1] 陈鹭[1] 马军梅[1] 李爱华[1] 沈颖[1] 

机构地区：[1]首都医科大学附属北京儿童医院肾内科,100045

出　　处：《北京医学》2012年第4期291-294,共4页Beijing Medical Journal

基　　金：首都医学发展科研基金(2007-2061);北京市优秀人才培养资助个人项目(2009D003008000001)

摘　　要：目的观察维持性血液透析(maintenance hemodialysis,MHD)患儿血浆脑钠肽(BNP)水平,初步探讨血浆BNP在判断儿童MHD容量状态中的意义。方法采用微粒子酶免疫分析法对23例(56例次)因终末期肾病(ESRD)行MHD患儿血液透析前后血浆BNP的水平进行检测,并与50例健康儿童进行比较,BNP异常增高者下调干体重后分析其水平变化。结果对照组男26例,女24例;年龄5岁1个月～12岁6个月;BNP水平(48.31±19.60)pg/ml,与年龄无相关性,性别间差异无统计学意义。MHD患儿透析前BNP水平为228.77pg/ml(17.67～3375.42),3例>4000pg/ml;透析后BNP为199.22pg/ml(8.87～2758.00),透析后BNP水平明显下降,与透析前比较差异有统计学意义。MHD患儿血浆BNP水平明显高于正常对照组(P<0.01)。3例BNP异常增高者无心力衰竭表现,有心房、心室扩大,下调干体重后BNP明显下降。结论 MHD患儿血浆BNP水平明显升高,BNP水平可以反映MHD患儿的容量状态。Objective To explore the value of plasma BNP levels in evaluating blood volume status in children on maintenance hemodialysis （MHD）. Methods Plasma BNP levels were determined with microparticle enzyme immunoassay before and after in 56 hemodialysis of 23 cases on MHD. Then, the changes of the indicators before and after hemodialysis were compared and compared with 50 normal controls. Results Twenty-six males and 24 females patients aged from 5.08 to 12.83 years were included in the control group. The levels of plasma BNP were （48.31±19.60）pg/ml and not correlated with age and gender. The median pre-HD, the post-HD plasma BNP levels were 228.77 pg/ml （17.67±3375.42） and 199.22 pg/ml （8.87±2758.00）espectively. The BNP levels were above 4000 pg/ml in 3 cases. The levels of plasma BNP after hemodialysis were significantly lower than before, but still significantly higher than that of the controls. The 3 cases whose BNP level were above 4000 pg/ml had no heart failure, but presented with enlarged atrium and ventricles. BNP decreased with decreased weight. Conclusion The plasma BNP levels can be used as an indicator for blood volume status assessment in hemodialysis children.

关 键 词：脑钠肽 维持性血液透析 儿童 

分 类 号：R726.91[医药卫生—儿科]