老年血液透析合并心力衰竭患者血清嗜铬粒蛋白A与B型钠尿肽和心功能分级的关系  

Relationship of serum chromogranin A and BNP levels with cardiac function in elderly chronic heart failure patients on hemodialysis

作　　者：邓承慧[1] 钟麟[1] 王慧清[2] 孙冬莉[3] Deng Chenghui;Zhong Lin;Wang Huiqing;Sun Dongli(Department of Nephrology,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning Province,China)

机构地区：[1]大连大学附属中山医院肾内科,116001 [2]大连大学附属中山医院心内科,116001 [3]大连大学附属中山医院妇科,116001

出　　处：《中华老年心脑血管病杂志》2019年第2期160-163,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年血液透析合并心力衰竭患者血清嗜铬粒蛋白A(CGA)与B型钠尿肽(BNP)和心功能分级的关系。方法选择2012年11月～2018年2月大连大学附属中山医院血液透析中心治疗的老年慢性肾功能衰竭患者86例,根据心功能(NYHA)分级分为心功能Ⅰ级组23例,心功能Ⅱ级组20例,心功能Ⅲ级组19例,心功能Ⅳ级组24例,同期选择健康体检者20例为对照组,检测血清CGA、BNP水平,并行心脏彩色超声检查,测量LVEF、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)等相关指标。用Pearson相关性分析CGA与心脏超声指标的关系。结果各组CGA和BNP水平比较,差异有统计学意义(P<0.01)。心功能Ⅰ级组、心功能Ⅱ级组、心功能Ⅲ级组和心功能Ⅳ级组CGA和BNP水平较对照组明显增高,差异有统计学意义(P<0.01)。心功能Ⅱ级组CGA和BNP水平较心功能Ⅰ级组明显升高,心功能Ⅲ级组CGA和BNP水平较心功能Ⅰ级组和心功能Ⅱ级组明显增高,心功能Ⅳ级组CGA和BNP水平较心功能Ⅰ级组、心功能Ⅱ级组和心功能Ⅲ级组明显增高,差异有统计学意义(P<0.01)。相关性分析显示,血清CGA与LVEF呈负相关(r=-0.702,P=0.016),与LVEDD、LVESD和LAD呈正相关(r=0.616,P=0.028;r=0.683,P=0.019;r=0.631,P=0.021)。结论检测CGA水平有助于判断老年血液透析合并慢性心力衰竭患者心力衰竭的严重程度。Objective To study the relationship of serum chromogranin A(CGA)and BNP levels with cardiac function in elderly CHF patients on hemodialysis.Methods Eighty-six elderly CHF patients admitted to our hospital from November 2012 to February 2018 were divided into cardiac functionⅠgroup(n=23),cardiac functionⅡgroup(n=20),cardiac functionⅢgroup(n=19)and cardiac functionⅣgroup(n=24)according to The NYHA,with 20 persons undergoing physical examination served as a control group.Their serum CGA and BNP levels,LVEDD,LVESD and LAD were measured and their LVEF was detected.Results The serum CGA and BNP levels were significantly different in cardiac functionⅠ-Ⅳgroups(P<0.01),and were significantly higher in cardiac functionⅠ-Ⅳgroups than in control group(P<0.01),in cardiac functionⅡgroup than in cardiac functionⅠgroup,in cardiac functionⅢgroup than in cardiac functionⅠandⅡgroups,in cardiac functionⅣgroup than in cardiac functionⅠ-Ⅲgroups(P<0.01).Pearson correlation analysis showed that serum CGA level was negatively related with LVEF(r=-0.702,P=0.016)and positively related with LVEDD,LVESD and LAD(r=0.616,P=0.028;r=0.683,P=0.019;r=0.631,P=0.021).Concluion Measurement of serum CGA level helps to assess the severity of HF in elderly CHF patients on hemodialysis.

关 键 词：肾透析 心力衰竭 嗜铬粒蛋白质A 尿毒症 利钠肽 脑 

分 类 号：R541.6[医药卫生—心血管疾病] R692.5[医药卫生—内科学]