2型糖尿病患者BNP水平与左心室舒张功能的关系  

Association of plasma brain natriuretic peptide level and left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus

作　　者：江姝 仇怡 缪羽霞 刘霞[1] 张敏[2] 徐敏[1] JIANG Shu(Department of ultrasound cardiogram,the first people's hospital of Changzhou,Changzhou,Jiangsu,213003,China)

机构地区：[1]常州市第一人民医院超声心动图科,江苏常州213000 [2]常州市第一人民医院营养科,江苏常州213000

出　　处：《齐齐哈尔医学院学报》2020年第8期925-928,共4页Journal of Qiqihar Medical University

摘　　要：目的评价2型糖尿病(Type 2 Diabetes Mellutis,T2DM)患者的血浆脑型钠利尿肽(B-natriuretic peptide,BNP)水平与左心室舒张功能的关系,并进一步分析影响T2DM患者血浆BNP水平的危险因素。方法选择2018年5月—2019年5月本院内分泌科收治的T2DM患者190例作为研究对象,根据美国超声心动图协会及欧洲心血管成像协会(ASE/EACVI)2016左心室舒张功能诊断指南,分为左心室舒张功能正常组(n=140)及左心室舒张功能障碍组(n=50)两组。收集患者血脂、超敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)、血浆BNP、心肌肌钙蛋白I(cardiactroponin I,cTn I)、肌酐、空腹血糖,血压等参数,比较两组参数差异。二元logistic回归分析T2DM患者左心室舒张功能异常的独立危险因素。分析BNP等血液指标诊断左心室舒张功能异常的ROC曲线。单因素及多因素线性回归分析影响BNP水平的指标。结果左心室舒张功能障碍组与左心室舒张功能正常组相比,BNP、收缩压(systemic blood pressure,SBP)、空腹血糖均显著升高(P<0.05)。BNP是T2DM患者左心室舒张功能异常的独立危险因素。BNP诊断T2DM患者左心室舒张功能障碍的曲线下面积(AUC)为0.755(95%CI:0.684~0.827,P=0.001)。单因素相关分析结果提示,T2DM患者血浆BNP水平与肌酐、hs-CRP、SBP呈正相关。多元线性回归分析结果提示:肌酐、hs-CRP、SBP是T2DM患者BNP水平的独立危险因素(F=12.2,P=0.001)。结论BNP水平升高是T2DM患者左心室舒张功能障碍的生物标志物,且肌酐、hs-CRP、SBP是T2DM患者BNP水平的独立危险因素。Objective To evaluate the association of plasma brain natriuretic peptide(BNP)level and left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus and to analyze the risk factors for increased BNP levels in this population.Methods From May 2018 to May 2019,a total of 190 patients with T2 DM in the department of endocrinology of our hospital were selected as study subjects,and they were divided into left ventricular diastolic function normal group(n=140)and left ventricular diastolic dysfunction group(n=50)according to the diagnostic guidelines of American echocardiography association and European society of cardiovascular imaging(ASE/EACVI)2016.Parameters such as blood lipid,hypersensitive C-reactive protein,plasma BNP,cardiac troponin I(cTn I),creatinine,fasting blood glucose and blood pressure were collected,and the differences between the two groups were analyzed.The independent risk factors of left ventricular diastolic dysfunction in patients with T2 DM were analyzed by binary logistic regression.The ROC curve of diagnosis of left ventricular diastolic dysfunction with BNP and other blood indicators were analyzed.Univariate and multivariate linear regression analysis was performed to investigate the indicators affecting BNP level.Results Plasma BNP levels,fasting blood glucose,and systolic blood pressure were significantly higher in patients with left ventricular diastolic dysfunction than in those without left ventricular diastolic dysfunction(P<0.05).BNP is an independent risk factor for abnormal left ventricular diastolic function in patients with T2 DM.The area under the curve(AUC)that BNP was used to diagnosed left ventricular diastolic dysfunction was 0.755(95%CI:0.684-0.827,P=0.001).Plasma BNP levels had significantly positive correlation with SBP,hs-CRP and creatinine.Stepwise multiple regression analysis further revealed that SBP,hs-CRP and creatinine were independent risk factors for increased BNP levels(F=12.2,P=0.001).Conclusions Plasma BNP level is a biomarker for assessing

关 键 词：脑型钠利尿肽 2型糖尿病 左心室舒张功能 

分 类 号：R587.1[医药卫生—内分泌]