不同NT-proBNP水平慢性肾脏病透析患者人体成分、营养状况及心功能状况  

Body Composition,Nutritional Status and Cardiac Function of Dialysis Patients with Chronic Kidney Disease at Different Level of NT-ProBNP

作　　者：李倩倩[1] 王建刚[2] 刘新宇[2] LI Qianqian;WANG Jiangang;LIU Xinyu(Clinical Medical School,Henan university,Kaifeng 475000,China;Department of Blood Purification,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南大学临床医学院,河南开封475000 [2]南阳市中心医院血液净化科,河南南阳473000

出　　处：《河南医学研究》2023年第7期1189-1195,共7页Henan Medical Research

摘　　要：目的分析不同氨基末端脑钠肽前体(NT-proBNP)水平慢性肾脏病(CKD)透析患者人体成分、营养状况及心功能状况,为相关并发症的识别、诊断、治疗及动态监测提供理论依据。方法选择南阳市中心医院2020年10月至2021年12月收治的110例CKD透析患者,根据透析前血清NT-proBNP水平将其分为低NT-proBNP组(NT-proBNP<7000 ng·L^(-1))和高NT-proBNP组(NT-proBNP≥7000 ng·L^(-1)),然后以透析模式为亚组分组依据,收集患者一般资料、人体成分分析、血液检查指标和心脏超声检查指标,对比患者的人体成分、营养相关生化指标及心功能相关指标。结果(1)高NT-proBNP组患者水负荷、左室收缩末期内径、左室收缩末期容积水平均高于低NT-proBNP组(P<0.05),体重指数、总蛋白、甘油三酯、左室射血分数水平均低于低NT-proBNP组(P<0.05)。对于差异有统计学意义的变量进行亚组分析,结果显示:在血液透析患者中,低NT-proBNP组与高NT-proBNP组患者水负荷、左室收缩末期内径、体重指数、甘油三酯、左室射血分数差异有统计学意义(P<0.05);在腹膜透析患者中,低NT-proBNP组与高NT-proBNP组患者仅有左室收缩末期内径差异有统计学意义(P<0.05)。(2)Spearman相关性分析和logistic回归分析结果显示:水负荷、左室收缩末期内径、左室收缩末期容积水平与NT-proBNP水平呈正相关(r=0.347、0.234、0.219,P<0.05),甘油三酯、左室射血分数与NT-proBNP水平呈负相关(r=-0.307、-0.218,P<0.05),水负荷与NT-proBNP水平独立相关(OR=1.332,95%CI 1.032~1.720,P<0.05)。结论CKD透析患者血清NT-proBNP水平与容量负荷、营养状况及心功能密切相关,应定期监测人体成分与心功能,加强高NT-proBNP水平患者的营养指导与容量控制,进行个体化精准治疗,以减少相关并发症的发生,提高患者的生存质量。Objective To investigate the body composition,nutritional status and cardiac function of dialysis patients with chronic kidney disease(CKD)at different level of N-terminal pro-brain natriuretic peptide(NT-proBNP),in order to provide theoretical basis for the identification,diagnosis,treatment and dynamic monitoring of related complications.Methods A total of 110 CKD dialysis patients admitted to Nanyang Central Hospital from October 2020 to December 2021 were selected.According to the level of serum NT-proBNP before dialysis,they were divided into low NT-proBNP group(NT-proBNP<7000 ng·L^(-1))and high NT-proBNP group(NT-proBNP≥7000 ng·L^(-1)).Then,dialysis mode was used as the basis for subgroup grouping,and the general data,body composition analysis,blood test indexes and cardiac ultrasound indexes were collected,then the body composition,nutrition-related biochemical indexes and cardiac function indexes of patients in the two groups were compared.Results(1)The water load,left ventricular end-systolic diameter,left ventricular end-systolic volume were higher in the high NT-proBNP group than in the low NT-proBNP group(P<0.05).The body mass index,total protein,triglyceride and left ventricular ejection fraction were lower in the high NT-proBNP group than in the low NT-proBNP group(P<0.05).Subgroup analysis was conducted on variables with statistical differences.The results showed that water load,left ventricular end-systolic diameter,body mass index,triglyceride and left ventricular ejection fraction had statistical difference among hemodialysis patients(P<0.05).Only left ventricular end-systolic diameter had statistical difference among peritoneal dialysis patients(P<0.05).(2)Spearman correlation and binary logistic regression analysis indicated that water load,left ventricular end-systolic diameter,left ventricular end-systolic volume were positively correlated with NT-proBNP(r=0.347,0.234,0.219,P<0.05),triglyceride and left ventricular ejection fraction were negatively correlated with NT-proBNP(r=-0.307,-0.2

关 键 词：N末端B型利钠肽原 慢性肾脏病 人体成分 营养状况 心功能 

分 类 号：R692.9[医药卫生—泌尿科学]