sCD146和NT-proBNP在腹膜透析患者水负荷评估中的作用  

The Role of sCD146 and NT-proBNP in the Assessment of Hydration State of Peritoneal Dialysis Patients

作　　者：杨林[1] 王佩佩 李阿芳 张蓓[2] 窦艳娜[2] YANG Lin;WANG Peipei;LI Afang(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou City,He’nan Province 450000)

机构地区：[1]郑州大学第一附属医院小儿外科,河南省郑州市450000 [2]郑州大学第一附属医院肾脏内科,河南省郑州市450000

出　　处：《医学理论与实践》2022年第13期2172-2175,2200,共5页The Journal of Medical Theory and Practice

基　　金：国家自然科学基金资助项目(U1404804)。

摘　　要：目的:探讨可溶性CD146(soluble CD146,sCD146)和NT-proBNP在腹膜透析患者水负荷状态评估中的作用。方法:纳入我院住院持续非卧床腹膜透析(PD)的患者48例作为PD组,另纳入同期健康人30例作为对照组。两组均收集临床资料,使用生物电阻抗仪器测定体内多余水量(M_(exf)),并测定血浆sCD146浓度、NT-proBNP及其他实验室指标。根据体内多余水量将透析患者分为水负荷过多组和水负荷正常组,计算sCD146和NT-proBNP诊断水负荷状态的AUC面积、敏感性和特异性。结果:PD组的血sCD146水平和NT-proBNP水平明显高于正常组。水负荷过多组36例,水负荷正常组12例;与水负荷正常组相比,水负荷过多组sCD146水平有升高趋势,但差异无统计学意义(P>0.05)。水负荷过多组的NT-proBNP水平高于水负荷正常组(P<0.05)。PD患者的sCD146、NT-proBNP水平对诊断PD患者水负荷过多的曲线下面积(AUC)为0.63(95%CI 0.46~0.80,P<0.05)和0.74(95%CI 0.57~0.92,P<0.05)。sCD146的最佳截断值为720.8ng/ml(敏感性36.1%,特异性91.7%),NT-proBNP的最佳截断值为12852pg/ml(敏感性69.4%,特异性75.0%)。结论:在PD患者中,sCD146可以在腹膜透析患者水负荷状态的评估中发挥一定作用,NT-proBNP或许是评估容量负荷更良好的指标。Objective:To explore the role of soluble CD146(sCD146)and NT-proBNP in the assessment of hydration state in peritoneal dialysis(PD)patients.Methods:48 patients who underwent peritoneal dialysis in our hospital were enrolled as PD group.30 healthy people were enrolled as control group.The clinical data were collected in both groups.Excess water volume(M_(exf))was calculated by bioelectrical impedance method.Plasma sCD146,NT-proBNP and other laboratory indexes were measured at the same time.According to the excess water in the body,PD patients were divided into two groups:the overhydration group and normal hydration group.The AUC area,sensitivity and specificity of sCD146 and NT-proBNP were calculated.Results:The sCD146 level and NT-proBNP in PD group were significantly higher than those in the control group(P<0.05).There were 36 cases in the overhydration group and 12 cases in the normal hydration group.Compared with the normal hydration group,there was an increased trend in the plasma level of sCD146 in overhydration group,but the difference was not statistically significant(P>0.05).The NT-proBNP level of overhydration group was significantly higher than that of normal hydration group(P<0.05).The area of AUC was 0.63(95%CI 0.46~0.80,P<0.05)and 0.74(95%CI 0.57~0.92,P<0.05)for diagnosis of overhydration state with sCD146 and NT-proBNP levels in PD patients.The best truncation value of sCD146 was 720.8ng/ml(sensitivity 36.1%,specificity 91.7%),and NT-proBNP was 12852pg/ml(sensitivity 69.4%,specificity 75.0%).Conclusion:sCD146 could play a role in the assessment of hydration state in PD patients.NT-proBNP may be a better indicator to evaluate the hydration state in PD patients.

关 键 词：可溶性CD146 NT-PROBNP 水负荷状态 腹膜透析 

分 类 号：R445[医药卫生—影像医学与核医学]