重组人脑利钠肽结合床旁血液超滤对心肾综合征患者血清GDF-15、Obestatin表达的影响  

Effects of Recombinant Human Brain Natriuretic Peptide Combined withBedside Blood Ultrafiltration on Serum GDF-15 and ObestatinExpression in Patients with Cardiorenal Syndrome

作　　者：薛乾隆[1] 刘颖 胡金萍[3] 陆振宇 王慧江 韩树池[1] XUE Qianlong;LIU Ying;HU Jinping;LU Zhengyu;WANG Huijiang;HAN Shuchi(Emergency Department,First Affiliated Hospital of Hebei North College,Zhangjiakou 075000,China;Pediatric,First Affiliated Hospital of Hebei North College,Zhangjiakou 075000,China;Hebei North College,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院急诊科,河北张家口075000 [2]河北北方学院附属第一医院儿科,河北张家口075000 [3]河北北方学院,河北张家口075000

出　　处：《标记免疫分析与临床》2022年第8期1313-1318,共6页Labeled Immunoassays and Clinical Medicine

基　　金：河北省张家口市科学技术研究与发展计划项目(编号:1821061D)。

摘　　要：目的探究重组人脑利钠肽结合床旁血液超滤应用于心肾综合征患者,对其血清生长分化因子-15(GDF-15)和肥胖抑制素(Obestatin)表达的影响。方法选取2019年8月至2021年4月在我院收治的80例心肾综合征患者作为研究对象,随机分为观察组和对照组,每组40例。两组患者均先给予常规治疗措施,对照组采用床旁血液超滤,观察组在对照组的基础上给予重组人脑利钠肽治疗,比较两组患者在治疗前后的生命体征、APACHE-Ⅱ评分、心肺功能、肾功能、血钾水平、炎性因子、GDF-15和Obestatin水平。结果在治疗2周后,两组患者的生命体征指标呼吸频率(RR)、心率(HR)和APACHE-Ⅱ评分均明显降低,且观察组的RR、HR和APACHE-Ⅱ评分明显低于对照组,差异具有统计学意义(P<0.05);在治疗2周后,两组患者的心肺功能指标左室射血分数(LVEF)、心输出量(CO)和动脉血氧分压(PaO_(2))水平明显升高,中心静脉压(CVP)和外周血管阻力(SVR)水平明显降低,且观察组的各项指标改善程度明显优于对照组,差异具有统计学意义(P<0.05);在治疗2周后,两组患者的肾功能指标肌酐(SCr)、尿素氮(BUN)和血钾水平明显降低,且观察组的SCr、BUN和血钾水平显著低于对照组,差异具有统计学意义(P<0.05);在治疗2周后,两组患者的炎性因子超敏C反应蛋白(hs-CRP)和脑钠肽(BNP)水平明显降低,且观察组的hs-CRP和BNP水平明显低于对照组,差异具有统计学差异(P<0.05);在治疗后,两组患者的GDF-15和Obestatin水平明显降低,且相较于对照组,观察组的各项指标降低程度更明显,差异具有统计学意义(P<0.05)。结论重组人脑利钠肽结合床旁血液超滤对心肾综合征能够明显下调血清GDF-15和Obestatin的表达,对心肾综合征的治疗和预后评估具有重要的参考价值。Objective To explore the effect of recombinant human brain natriuretic peptide combined with bedside blood ultrafiltration applied in patients with cardiorenal syndrome on the expression of serum growth differentiation factor-15(GDF-15)and obestatin(Obestatin).Methods A total of 80 patients with cardiorenal syndrome who were admitted to our hospital from August,2019 to April,2021 were selected as the research objects,and these patients were randomly divided into the observation group and control group,with 40 cases in each group.Both groups of patients were given conventional treatment measures.The control group was treated with bedside blood ultrafiltration,and the observation group was treated with recombinant human brain natriuretic peptide in addition of the control group.The vital signs and APACHE-Ⅱscore of the two groups were compared before and after treatment,as well as cardiopulmonary function,renal function,blood potassium level,inflammatory factors,GDF-15 and Obestatin levels.Results After 2 weeks of treatment,the vital signs index respiratory frequency(RR),heart rate(HR)and APACHE-Ⅱscores of the two groups of patients were significantly reduced,and RR,HR and APACHE-Ⅱscores of the observation group were significantly lower than those of the control group with statistical significance(P<0.05);After 2 weeks of treatment,levels of left ventricular ejection fraction(LVEF),cardiac output(CO)and arterial partial pressure of oxygen(PaO_(2))of the two groups of patients were increased,while central venous pressure(CVP)and peripheral vascular resistance(SVR)levels were significantly reduced,and the improvement of various indicators in the observation group was significantly better than that of the control group,with significant differences(P<0.05);With 2 weeks of treatment after that,the renal function indexes creatinine(SCr),urea nitrogen(BUN)and blood potassium levels of the two groups of patients were significantly reduced,and SCr,BUN and blood potassium levels of the observation group were significant

关 键 词：心肾综合征 重组人脑利钠肽 床旁血液抽滤 

分 类 号：R446.11[医药卫生—诊断学]