血浆BNP与NT-proBNP在评价持续非卧床腹膜透析患者心功能中的作用  

Roles of serum BNP and NT-proBNP in evaluation of cardiac function in patients with continuous ambulatory peritoneal dialysis

作　　者：刘莉华[1] 汪燕[1] 邢蓓蓓[1] 王娟[1] 吴永贵[1] 

机构地区：[1]安徽医科大学第一附属医院肾内科,合肥230022

出　　处：《安徽医科大学学报》2017年第6期869-873,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金(编号:81270813);安徽高校自然科学研究重点项目(编号:KJ2016A343)

摘　　要：目的探讨血浆B型脑钠肽(BNP)与N末端脑钠肽前体(NT-proBNP)在持续非卧床腹膜透析(CAPD)患者心功能评价中的作用。方法检测54例CAPD患者及30例健康对照者血BNP与NT-proBNP水平,并行人体成分分析及无创血流动力学监测。结果 (1)CAPD组患者血BNP、NTproBNP明显高于对照组;(2)人体成分分析显示CAPD组患者水化分数细胞外水/总体水(ECW/TBW)明显高于对照组(P<0.05);(3)无创血流动力学监测提示CAPD组患者系统血管阻力(SVR)、胸液传导性(TFC)明显高于对照组(P<0.01),搏排量(SV)、射血前期(PEP)、左心室射血时间(LVET)明显低于对照组(P<0.01);(4)相关性分析显示血BNP与NT-proBNP及ECW/TBW呈正相关性(r=0.832、0.646,P<0.001);NT-proBNP与ECW/TBW呈正相关性(r=0.587,P<0.001);血BNP与SVR及TFC呈正相关性(r=0.334、0.446,P=0.013、0.001);NT-proBNP与SVR及TFC呈正相关性(r=0.315、0.324,P=0.020、0.017),与SV、LVET及VI呈负相关性(r=-0.401、-0.325、-0.396,P=0.003、0.017、0.003);(5)多元线性回归分析显示:ECW/TBW为血BNP独立相关变量,其标准化系数为0.663(P<0.001);ECW/TBW、SI及EF为NT-proBNP的相关变量,其标准化系数分别为0.475(P<0.001)、-0.596(P<0.001)、0.352(P=0.018)。结论 NT-proBNP在左心功能及后负荷的评价上优于血BNP,血BNP在容量负荷评估上优于NTproBNP。Objective To explore roles of serum B-type natriuretic petide （BNP） and N-terminal pro-brain natri- uretic peptide （NT-proBNP） in the evaluation of cardiac function in patients with continuous ambulatory peritoneal dialysis （CAPD）. Methods 54 CAPD patients （ CAPD group） and 30 healthy people （ control group） were included in the study. Serum BNP and NT-proBNP levels were tested, also body composition analysis and non-invasive he- modynamic monitoring were proceeded. Results （1） The levels of BNP and NT-proBNP in CAPD group were signif- icantly higher than those in control group; （2） ECW/TBW in CAPD group was higher than control group （P 〈 0. 05 ） ; （3） Noninvasive hemodynamics showed that systemic vascular resistance （SVR） and pleural fluid conductivi- ty （ TFC ） of CAPD were significantly higher than that of control group （ P 〈 0. 01 ） ; stroke volume （ SV）, cardiac in- dex（SI） ,pre-ejection period（PEP）, left ventricular ejection time（LVET） of CAPD group were significantly lower than control group（P 〈0. 01 ） ;（4） Correlation analysis showed that BNP was positively correlated with NT-proBNP and ECW/TBW （ r = 0. 832, 0. 646, P 〈 0. 001 ） ; NT-proBNP was positively correlated with ECW/TBW（ r = 0. 587, P 〈 0. 001 ） ;BNP was positively correlated with SVR and TFC（ r = 0. 334, 0. 446, P = 0. 013, 0. 001 ） ; NT-proBNP was positively correlated with SVR and TFC （r = 0. 315, 0. 324, P = 0. 020, 0. 017） , and negatively correlated with SV, LVET and VI（ r = -0. 401, -0. 325, -0. 396 ,P = 0. 003,0. 017, 0. 003 ） ;（5） The multiple liner regression analysis showed that ECW/TBW was independent variable associated with BNP, and its standard correlation coeffi- cient was 0. 663 （P 〈 0. 001 ） ; however, ECW/TBW, SV, and EF were the relevant variables of NT-proBNP, and those standard correlation coefficients were 0. 475 （ P 〈 0. 001 ）, - 0. 596 （ P 〈 0. 001 ）, 0. 352 （ P = 0. 018 ）. Con- clusion NT-proBNP

关 键 词：腹膜透析 NT-PROBNP 无创血流动力学 ECW/TBW 心功能 

分 类 号：R459.51[医药卫生—治疗学]