慢性肾脏病非透析患者脑钠肽前体异常的危险因素分析  

Study on risk factors of N-terminal pro-brain natriuretic peptide abnormalities in non-dialysis patients with chronic kidney disease

作　　者：金德伟 陶敏 马晓燕[1] 王奕[1] 盛丽莉 刘娜[1] JIN De-wei;TAO Min;MA Xiao-yan;WANG Yi;SHENG Li-li;LIU Na(Department of Nephrology,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200092,China)

机构地区：[1]同济大学附属东方医院肾内科,上海200092

出　　处：《中华全科医学》2021年第8期1314-1317,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81670690,81470991,81200492);上海市自然基金项目(20ZR1445800);浦东新区重点学科附带课题(PWZxk2017-05)。

摘　　要：目的研究慢性肾脏病(chronic kidney disease,CKD)非透析患者氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)异常的危险因素。方法选取2018年1月1日—2019年12月31日在东方医院肾内科入院治疗的259例CKD非透析患者。根据患者NT-proBNP水平将患者分为NT-proBNP正常组(Ⅰ组:NT-proBNP<125 ng/L)和NT-proBNP异常组(Ⅱ组:NT-proBNP≥125 ng/L),其中Ⅰ组患者129例,Ⅱ组患者130例。采用多因素logistic回归、ROC曲线分析患者NT-proBNP异常的影响因素。结果 Logistic回归分析显示高龄(P=0.008)为NT-proBNP异常的独立危险因素,高血红蛋白(P=0.014)、eGFR(P<0.001)水平为患者NT-proBNP异常的保护因素。ROC分析显示,当患者年龄>75.5岁(AUC=0.658,P<0.001),血红蛋白<124.5 g/L(AUC=0.769,P<0.001),eGFR<47.53 mL/(min·1.73 m^(2))(AUC=0.810,P<0.001)时,患者发生NT-proBNP增高的风险将显著增加。结论高龄为NT-proBNP异常的独立危险因素,高水平血红蛋白、eGFR是患者NT-proBNP异常的保护因素。Objective To investigate the risk factors of N-temiinal pro-brain natriuretic peptide(NT-proBNP)abnormalities in non-dialysis patients with chronic kidney disease(CKD).Methods Non-dialysis patients hospitalized in the Department of Nephrology from January 1,2018 to December 31,2019 at the Shanghai East Hospital were enrolled.According to the level of NT-proBNP,patients were divided into NT-proBNP normal group(Ⅰ:NT-proBNP<125 ng/L)and NT-proBNP abnormal group(Ⅱ:NT-proBNP≥125 ng/L).There were 129 patients in group Ⅰ and 130 patients in group Ⅱ.Multivariate Logistic regression and ROC curve were used to analyze the influencing factors of patients'NT-proBNF abnormalities.Results Logistic regression showed that age(P=0.008)was an independent risk factor for NT-proBNP abnormality,and hemoglobin(P=0.014)and eGFR(P<0.001)were protective factors for patients with NT-proBNP abnormality.ROC analysis showed that when the patients age was>75.5 years(AUC=0.658,P<0.001),hemoglobin<124.5 g/L(AUC=0.769,P<0.001),eGFR<47.5[mL/(min•1.73 m^(2))](AUC=0.810,P<0.001),the risk of NT-proBNP increase will increase significantly.Conclusion Age is an independent risk factor for the increase of NT-proBNP,while hemoglobin and eGFR are protective factors.

关 键 词：慢性肾脏病 氨基末端脑钠肽前体 危险因素 

分 类 号：R692[医药卫生—泌尿科学]