肾功能分级与充血性心衰患者血BNP Mb浓度的相关性研究  

Study on the Relationship between Renal Function Class and Brain Natriuretic Peptide Myoglobin Value in Patients with CHF

作　　者：王琦[1] 徐文[1] 王敏[1] 刘立[1] 

机构地区：[1]上海市长宁区同仁医院,上海200050

出　　处：《河北医学》2013年第1期6-9,共4页Hebei Medicine

摘　　要：目的:探索CHF患者血浆B型脑钠尿肽(Brain natriuretic peptide,BNP)、血清肌红蛋白(Mb)、心力衰竭的分级(NYHA分级)与肾小球滤过率(glomeruar filtration rate,GFR)之间的关系。方法:选择2010年7月至2011年6月来我院社区门诊就诊的以冠心病合并有充血性心力衰竭患者273例,临床诊断为CHF,观察患者年龄、心功能、BNP、Mb、肾功能等多项指标。采用我国eGFR协作组于2006年发表了适合我国人群的简化MDRD公式来计算估计肾小球滤过率(estimated GFR,eGFR)。结果:血清BNP浓度随着肾功能越差呈现逐级升高,表明BNP检测在临床上有统计学显著意义(P<0.01),血清Mb浓度随着肾功能下降而升高,且具有显著的统计学意义(P<0.01),Spearman等级相关分析显示:eGFR分级与NYHA分级、BNP和Mb存在相关性,且eGFR相关性顺序依次为NYHA﹥Mb﹥BNP。eGFR与NYHA、Mb和BNP有显性回归关系。eGFR与NYHA、Mb和BNP呈明显的负相关性。结论:肾功能与血清BNP、Mb水平之间存在有相关性,血清BNP浓度随着肾功能越差呈现逐级升高,血清Mb浓度随着肾功能下降而升高,CHF合并有肾功能异常的患者十分常见,在临床上判断CHF患者的血清BNP、Mb对于心力衰竭的价值时应关注肾功能的状况,有助于减少误诊、漏诊和病情估测的准确性。Objective： To evaluate the relationship between brain natriuretic peptide（BNP）,myoglobin（Mb）,NYHA class and（GFR） in patients with congestive heart failure（CHF）.Method： 273 patients with CHF were selected in our hospital from July 2010 to June 2011.The age,cardiac function,BNP,Mb,renal function were measured.The estimated GFR was calculated by MDRD formula using for patients in China which was published by eGFR in 2006.Result： The BNP values were increased as renal function became worse.It was regarded as significant（P0.01）.The Mb values were also increased as renal function became worse.It was regarded as signigicant（P0.01）.Spearman rank correlation analysis showed that not only EGFR and NYHA,but also BNP and MB has correlation.The correlation coefficient is NYHA﹥Mb﹥BNP.eGFR and NYHA Linear regression.Mb and BNP Linear regression eGFR were negative correlated with NYHA.And MB were negative correlated with BNP too.Conclusion： The renal function has correlation with the plasma level of BNP and Mb.The BNP values are increased as renal function become worse.The Mb values are also increased as renal function become worse.Patients with CHF and renal function impaired is very common.

关 键 词：充血性心力衰竭 肾功能 B型脑钠尿肽 血清肌红蛋白 

分 类 号：R541.6[医药卫生—心血管疾病]