N端脑钠肽前体评估腹膜透析患者容量负荷的应用价值研究  

作　　者：黄琳[1] 王晓中[2] 于畅[3] 臧宇婷[3] 

机构地区：[1]大连市友谊医院肾内科,辽宁116001 [2]辽宁出入境检验检疫局卫生检疫监管处 [3]辽宁国际旅行卫生保健中心

出　　处：《当代医学》2016年第2期1-3,共3页Contemporary Medicine

摘　　要：目的探索NT-pro BNP在腹膜透析患者容量负荷评估中的临床应用价值。方法选取腹膜透析(PD)患者42例为研究对象,进入观察前个体化透析处方,监测受试患者的血NT-pro BNP、Alb、Hb、Ca^(2+)、P^(3+)、PTH、SBP、DBP、Kt/V、LVDd、LVPWT、LVST、EF、CTR等,分析NT-pro BNP与各项指标的相关性。结果腹透患者NT-pro BNP水平[心衰组与非心衰组分别为(15171.30±14185.87),(2837.04±2167.14)较对照组(141.25±87.20)明显升高(P<0.05)];患者血压与NT-pro BNP水平呈显著正相关(SBP:r=0.468,P<0.05;DBP:r=0.509,P<0.05);NT-pro BNP水平与ALB、HB呈负相关(r=-0.206、-0.311),与CHOL呈正相关(r=0.34);心衰组(1.39±0.26)与非心衰组(1.73±0.15)腹透患者KT/V与血NT-pro BNP水平呈正相关(r=0.270);CTR在腹透患者中升高,与NT-pro BNP呈正相关(r=0.557,P<0.01);LVDd在心衰组与非心衰组有增高[女性心衰组与非心衰组分别为(60.83±5.85)、(47.17±5.49),与对照组(43.33±5.65)相比,差异有统计学意义(P<0.05);男性心衰组与非心衰组分别为(66.17±6.94)、(52.67±2.58),与对照组(50.67±2.88)相比,差异有统计学意义(P<0.05)];心衰组EF明显下降(P=0.009);LVPWT、LVST在腹透患者之间比较差异无统计学意义,但与对照组比较差异有统计学意义(P=0.080、0.054)。血NT-pro BNP水平与LVDd(女性r=0.398,男性r=0.784,P<0.01),LVPWT(r=0.456,P<0.05),LVST(r=0.442,P<0.05)均呈正相关,与EF呈负相关(r=-0.363)。结论腹膜透析患者血NT-pro BNP水平明显升高,升高的程度与心功能分级有关,可作为评估腹膜透析患者心功能及容量负荷的指标。Objective To explore the clinical value of NT-proBNP in peritoneal dialysis （PD） patients in the assessment of the volume load. Methods Forty-two peritoneal dialysis patients were chosen for the study, individual dialysis prescription was made before they entered the observation, the patient＇s blood tested NT-proBNP, Alb, Hb, Ca2＋, P 3＋, PTH, SBP, DBP, Kt/V, LVDd, LVPWT, LVST, EF, CTR, etc. were monitored, and the correlation of NT-proBNP and indexes above mentioned were analyzed. Results NT-proBNP levels（heart failure group and non-heart-falure group were 15171.30±14185.87, 2837.04±2167.14 separately） in PD patients were markedly elevated compared with control group （141.25±87.20） （P〈0.05）, patients＇ blood pressure were significantly positively correlated with NT-proBNP levels （SBP： r=0.468, P〈0.05; DBP： r=0.509,P〈0.05）; NT-proBNP level was negatively correlated with ALB and HB separately （r=-0.206, -0.311）, and positively correlated with CHol （r=0.34）; KT/V in heart-failure （HF） group （1.39±0.26） and non-HF group （1.73±0.15） was significantly positively correlated with NT-proBNP level （r=0.270）; CTR was increased in PD patients, and was significantly positively correlated with NT-proBNP （r=0.557, P〈0.01）; LVDd in HF group and non-HF group were increased （Female： HF group and non-HF group were （60.83±5.85）, （47.17±5.49） separately, control group was （43.33±5.65） （P〈0.05）; Male： HF group and non-HF group were （66.17±6.94）, （52.67±2.58） separately, control group was （50.67±2.88） （P〈0.05）; EF in HF group was significantly decreased （P=0.009）; LVPWT, LVST have no difference between the PD patients, but were significantly different when compared with control group （P= 0.080, 0.054）. NT-proBNP blood level was positively correlated with LVDd （Female： r=0.398; Male： r=0.784, P〈0.01）, LVPWT （r=0.456, P〈0.05）, LVST （r=0.442,P〈0.05）, and was negatively correlated with EF. Co

关 键 词：N端脑钠肽前体 腹膜透析 容量负荷 心功能不全 

分 类 号：R459.5[医药卫生—治疗学]