非透析慢性肾脏病患者NT-ProBNP的影响因素  

The Influencing Factors of NT-proBNP in Patients with Non-dialysis Chronic Kidney Disease

作　　者：毛逸鸣 唐慧莉 贾蒙[1] 王怡[1] 徐艳秋[1] MAO Yiming;TANG Huili;JIA Meng(Department of Nephrology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437;不详)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院肾内科,上海200437 [2]上海市长宁区天山中医医院肾内科,上海200051

出　　处：《中国中西医结合肾病杂志》2025年第3期214-217,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市2021年度科技“创新行动计划”医学创新研究专项项目(No.21Y11922900)。

摘　　要：目的:NT-ProBNP通过肾脏代谢,在慢性肾脏病患者中不能准确评价其心功能,进一步探究可能影响非透析慢性肾脏病NT-ProBNP水平的相关因素。方法:收集513例非透析慢性肾脏病患者一般情况,心脏超声数据和肾功能、NT-ProBNP等生化指标。采用相关分析及多元线性回归分析NT-ProBNP的影响因素。结果:慢性肾脏病分期升高,NT-ProBNP浓度明显升高;在不同原发病中,DKD的NT-ProBNP浓度明显高于其他原发病(P<0.05);有心脏结构异常的NT-ProBNP浓度明显升高,与无心脏结构异常比较,差异有统计学意义(P<0.05)。多元线性回归分析显示慢性肾脏病NT-ProBNP与LVDs、Scr、cTnT、心脏结构异常、SUA、CK、冠心病、LVEF、Hb之间存在相关性(P<0.05),慢性肾脏病1~3期、4~5期以及不同原发病的NT-ProBNP相关因素存在差异。结论:NT-ProBNP随着肾功能下降而升高,心肌损伤、LVDs、Hb、SUA都是影响NT-ProBNP的相关因素。无论是否有心脏结构异常,糖尿病肾脏病的NT-ProBNP显著高于其他原发病。Objective:NT-ProBNP is metabolized through the kidneys,and cardiac function cannot be accurately evaluated in patients with chronic kidney disease.To further explore the relevant factors that may affect NT-ProBNP levels in non-dialysis chronic kidney disease.Methods:Age,gender,primary disease,past history,medication use,cardiac ultrasound data,renal function,NT-ProBNP,cardiac enzyme profile,troponin,hemoglobin,serum albumin,and 24 h urine protein were collected from 513 patients with non-dialysis chronic kidney disease.Correlation analysis and multiple linear regression were used to analyze the influencing factors of NT-ProBNP.Results:NT-ProBNP were significantly higher in chronic kidney disease with elevated CKD stage;among different primary diseases,NT-ProBNP were significantly higher in DKD than in other primary diseases(P<0.05);NT-ProBNP were significantly higher in those with cardiac structural abnormalities,and the difference was statistically significant when compared with those without cardiac structural abnormalities(P<0.05).Multiple linear regression analysis showed correlations between NT-ProBNP and LVDs,Scr,cTnT,cardiac structural abnormalities,SUA,CK,coronary artery disease,LVEF,and Hb in chronic kidney disease(P<0.05),and differences in factors associated with NT-ProBNP in CKD stages 1~3,CKD stages 4~5,and in different primary diseases.Conclusion:NT-ProBNP increased with decreasing renal function,and myocardial injury,LVDs,Hb,and SUA were all relevant factors affecting NT-ProBNP.NT-ProBNP was significantly higher in diabetic kidney disease than in other primary conditions,regardless of the presence of structural cardiac abnormalities.

关 键 词：慢性肾脏病 NT-PROBNP 糖尿病肾脏病 贫血 高尿酸血症 左心室收缩末期内径 

分 类 号：R692[医药卫生—泌尿科学]