NT-proBNP在糖尿病腹膜透析人群中的临床价值研究  

Study on the Clinical Value of NT-proBNP in Diabetic Peritoneal Dialysis Population

作　　者：乔诚 赵黎[1] 张海静[1] 倪燕萍 许涛[1] 汪年松[1] QIAO Cheng;ZHAO Lv;ZHANG Haijing(Department of Nephrology,Shanghai Sixth Hospital Affiliated to Shanghai Jiaotong University,Shanghai,200233)

机构地区：[1]上海交通大学附属第六人民医院肾内科

出　　处：《中国中西医结合肾病杂志》2019年第6期487-491,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然基金面上项目(No.81400735,81670657);国家自然基金青年项目(No.81300560);上海浦江人才计划项目(No.17PJ1407700);上海交通大学转化医学创新基金资助项目(No.152H2011);上海市徐汇区重点项目(No.SHXH201648);上海市综合医院中西医结合专项项目(No.ZHYY-ZXYJHZX-201608)

摘　　要：目的:探讨维持性腹膜透析患者合并糖尿病人群中血清N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-pro BNP)水平的变化及意义。方法:选取2013年01月~2018年12月在上海市交通大学附属第六人民医院集团维持性腹膜透析患者共348例,将患者分为糖尿病组(178例)与非糖尿病组(170例),通过统计患者一般情况,检测血清NT-pro BNP水平,分析组间差异及与临床病理生理特征的关系,受试者工作特征曲线(receiver operating characteristic,ROC)分析NT-pro BNP在糖尿病腹膜透析中的诊断价值,Logistic回归分析NT-pro BNP对糖尿病腹膜透析发生心衰的风险评估意义。结果:糖尿病组患者的NT-pro BNP水平高于非糖尿病组,结果差异具有统计学意义(P<0.05),ROC曲线分析显示,NT-pro BNP在糖尿病腹膜透析患者的曲线下面积(area under curve,AUC)为AUC为0.973(95%Cl:0.95~0.99,P<0.001),灵敏度为100%,特异性为73.8%。多项Logistic回归分析表明,NT-pro BNP是糖尿病腹膜透析发生心衰的独立危险因素(P<0.05)。结论:在维持性腹膜透析合并糖尿病患者发生心血管事件的概率更大,血清NT-pro BNP对糖尿病腹膜透析病人的心血管事件发病的诊断、发病风险评估有重要意义。Objective: to investigate the changes and significance of serum n-terminal pro-brain natriuretic peptide(NTpro BNP) levels in patients with maintenance peritoneal dialysis combined with diabetes mellitus. Methods: We choose maintenance peritoneal dialysis patients 144 cases between January 2016 and December 2016 in Shanghai 6 th hospital group,patients can be divided into diabetic group(178 cases) and non-diabetic group(170 cases),detection personal basic information,serum level of NT-pro BNP,analysis of NT-pro BNP level differences between the two groups,and the relationship with clinical pathological physiological characteristics,the receiver-operating characteristic curve(receiver operating characteristic,ROC) analysis the NT-pro BNP in diagnostic value in diabetes peritoneal dialysis,Logistic regression analysis of the value of nt-probnp in the risk assessment of heart failure in diabetic peritoneal dialysis.Results: the level of nt-probnp in the diabetic group was higher than that in the non-diabetic group,the difference was statistically significant(P< 0. 05),ROC curve analysis showed that the area under curve(AUC) of nt-probnp in diabetic peritoneal dialysis patients was 0.973(95%Cl: 0.95 ~ 0.99,P< 0.001),the sensitivity was 100%,specificity was73.8%.Multinomial Logistic regression analysis showed that nt-probnp was an independent risk factor for heart failure in diabetic peritoneal dialysis(P<0.05).Conclusion: in the peritoneal dialysis population,the probability of cardiovascular events with diabetes mellitus is greater,serum nt-probnp on diabetes peritoneal dialysis patients with cardiovascular events diagnosis,risk assessment is of great significance.

关 键 词：糖尿病 腹膜透析 NT-PROBNP 

分 类 号：R587.2[医药卫生—内分泌] R692.5[医药卫生—内科学]