维持性血液透析患者血浆NT-proBNP与体液分布、营养状况关系研究  

Study on the relationship between plasma NT-proBNP,body fluid distribution and nutritional status in maintenance hemodialysis patients

作　　者：崔红蕊[1] 杨洪娟[1] 徐保振 王静[1] 高玉伟 王兴华 胡秀红[1] Cui Hongrui;Yang Hongjuan;Xu Baozhen;Wang Jing;Gao Yuwei;Wang Xinghua;Hu Xiuhong(Department of Nephrology,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院肾内一科,石家庄050031

出　　处：《广西医科大学学报》2022年第7期1112-1117,共6页Journal of Guangxi Medical University

基　　金：河北省医学科学研究指导课题计划项目(No.20190473)。

摘　　要：目的:观察维持性血液透析(MHD)患者血浆NT-proBNP水平与体液分布及营养不良的关系,并分析其临床价值。方法:选取2018年8月至2021年8月河北医科大学第一医院肾内科收治的50例MHD患者作为观察组,并将其按血浆NTproBNP水平不同分为低NT-proBNP组(n=25)和高NT-proBNP组(n=25),同期选取本院体检正常的50例健康人作为对照组。检测各组心功指标[左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室质量指数(LVMI)]、体液分布指标[总体水含量(TBW)、细胞外液含量(ECW)、细胞内液含量(ICW)]及营养不良指标[改良主观综合营养评估法(MQSGA)、血清白蛋白(Alb)]。绘制受试者工作特征(ROC)曲线,分析NT-proBNP预测心血管事件的效能。结果:观察组NT-proBNP、LVEDd、LVESD、LVMI、ECW和MQSGA评分高于对照组,LVEF、TBW和Alb低于对照组(均P<0.05)。心血管事件组血浆NT-proBNP水平高于未发生心血管事件组(P<0.05)。血浆NT-proBNP预测心血管事件的ROC曲线下面积(AUC)为0.742,灵敏度0.579,特异度为0.871。结论:MHD患者血浆NT-proBNP与心功能指标、ECW、TBW、MQSGA评分及Alb相关,且血浆NT-proBNP可预测MHD合并心血管事件。Objective:To observe the relationship between plasma NT-proBNP level,body fluid distribution and malnutrition in maintenance hemodialysis(MHD)patients,and to analyze its clinical value.Methods:Fifty patients with MHD treated in the Department of Nephrology,The First Hospital of Hebei Medical University from August 2018 to August 2021 were selected as the observation group.According to the level of plasma NT-proBNP,they were divided into low NT-proBNP group(n=25)and high NT-proBNP group(n=25).In the same period,50 healthy subjects with normal physical examination were selected as control group.The indexes of cardiac function(left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI)),body fluid distribution index(total body water(TBW),extracellular water(ECW),intracellular water(ICW))and malnutrition index(modified quantitative subjective global assessment(MQSGA),serum albumin(Alb))were measured.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of NT-proBNP in predicting cardiovascular events.Results:The scores of NT-proBNP,LVEDd,LVESD,LVMI,ECW and MQSGA in the observation group were higher than those in the control group,while the scores of LVEF,TBW and Alb in the observation group were lower than those in the control group(all P<0.05).The level of plasma NT-proBNP in the cardiovascular event group was higher than that in the non-cardiovascular event group(P<0.05).The area under the curve(AUC)of ROC of plasma NT-proBNP for predicting cardiovascular events was 0.742,the sensitivity was 0.579,and the specificity was 0.871.Conclusion:Plasma NTproBNP in patients with MHD is correlated with cardiac function index,ECW,TBW,MQSGA scores and Alb,and plasma NT-proBNP can predict MHD complicated with cardiovascular events.

关 键 词：维持性血液透析 NT-PROBNP 心血管事件 体液分布 营养状况 

分 类 号：R692.5[医药卫生—泌尿科学]