尿毒症患者血液透析前后血清NT-proBNP、BUA、cTnT水平变化及其临床意义  

The changes and clinical significance of serum NT-proBNP,BUA,cTnT levels in patients with uremia before and after hemodialysis

作　　者：谢希[1] 刘莉莉[1] 李书会[1] XIE Xi;LIU Lili;LI Shuhui(Department of Nephrology,People's Hospital of China Three Gorges University,Yichang,Hubei,China,443000)

机构地区：[1]三峡大学人民医院肾内科

出　　处：《分子诊断与治疗杂志》2019年第4期320-324,328,共6页Journal of Molecular Diagnostics and Therapy

摘　　要：目的探讨尿毒症患者血液透析前后血清氨基末端脑钠肽前体(NT-proBNP)、血尿酸(BUA)、肌钙蛋白T(cTnT)水平变化及其临床意义。方法选取2013年9月至2018年1月本院血液透析治疗的尿毒症患者160例,依据心血管疾病发生情况分为发生组(n=124)和未发组(n=36),同期选取健康人员作为健康对照组(n=160),检测所有人员血清NT-proBNP、BUA、cTnT水平,分析血清NT-proBNP、BUA、cTnT水平变化与心血管疾病的关系。结果尿毒症患者血清NT-proBNP、BUA、cTnT水平明显高于健康对照组,差异有统计学意义(P<0.05);发生组和未发组血液透析后血清NT-proBNP、BUA、cTnT水平明显低于透析前,未发组血液透析后血清NT-proBNP、BUA、cTnT水平明显低于发生组,差异有统计学意义(P<0.05);单因素分析结果显示,年龄(>60岁)、糖尿病、高血压和血液透析后血清NT-proBNP>4 381 ng/L、BUA>420μmol/L、cTnT>0.1μg/L水平与患者心血管疾病的发生有关(P<0.05);Cox回归性分析结果显示,校正年龄、糖尿病、高血压后,NT-proBNP>4 381 ng/L、BUA>420μmol/L、cTnT>0.1μg/L仍与患者心血管疾病的发生有明显的相关性(P<0.05)。结论尿毒症患者血液透析后血清NT-proBNP、BUA、cTnT水平下降,透析后NT-proBNP>4 381 ng/L、BUA>420μmol/L、cTnT>0.1μg/L与心血管疾病的发生密切相关。Objective To explore the changes and clinical significance of serum N-terminal pro brain natriuretic peptide(NT-proBNP),blood uric acid(BUA),troponin T(cTnT)levels before and after hemodialysis in uremic patients. Methods 160 patients with uremia who underwent hemodialysis in our hospital from September 2013 to January 2018 were enrolled. According to the cardiovascular disease,all patients were divided into occurrence group(n=124)and undeveloped group(n=36). In the same period,healthy people were selected as healthy control group(n=160). The levels of serum NT-proBNP,BUA and cTnT were measured in all subjects. The relationship between serum NT-proBNP,BUA and cTnT levels and cardiovascular disease was analyzed. Results The levels of serum NT-proBNP,BUA and cTnT in uremic patients were significantly higher than those in healthy controls(P<0.05). The serum NT-proBNP,BUA and cTnT levels after hemodialysis in the occurrence group and undeveloped group were significantly lower than those in the before hemodialysis. The serum NT-proBNP,BUA and cTnT levels after hemodialysis in the occurrence group were significantly lower than those in the undeveloped group(P<0.05). Univariate analysis results showed,the age(> 60 years old),diabetes,hypertension and blood serum after hemodialysis NT-proBNP >4 381 ng/L,BUA >420 mol/L,cTnT >0.1 μg/L were associated with the occurrence of cardiovascular disease(P<0.05). The Cox regression analysis results showed that,the correction of age,diabetes,hypertension,NT-proBNP(>4 381 ng/L),BUA(>420 μmol/L),cTnT(>0.1 μg/L)were still statistically associated with the occurrence of cardiovascular disease in patients(P<0.05). Conclusions The serum NT-proBNP,BUA,cTnT levels were decreased after hemodialysis in uremic patients NT-proBNP(>4 381 ng/L),BUA(>420 μmol/L)and cTnT(>0.1 μg/L)after hemodialysis were closely related to the occurrence of cardiovascular disease.

关 键 词：尿毒症 血液透析 氨基末端脑钠肽前体 血尿酸 肌钙蛋白T 心血管疾病 

分 类 号：R692.5[医药卫生—泌尿科学]