摘要
目的观察慢性肾脏病(CKD)非透析患者不同时期血浆脑钠肽前体(NT-proBNP)水平的变化,评价其与CKD患者心功能不全的关系。方法根据肾小球滤过率(eGFR)将86例CKD患者分为4组,CKDⅠ、Ⅱ期组8例,CKDⅢ期组26例,CKDlV期组24例,CKDV期组28例;同时选取30例健康体检者作为健康对照组。测量各组患者及健康对照者血浆NT-proBNP水平、左心室射血分数(LVEF)、左心室舒张末期内径(LVDd)、左心室收缩期内径(LVDs),计算左心室质量指数(LVMI)。比较各组NT-proBNP水平与心功能指标的关系。结果各组CKD患者血浆NT-proBNP水平与健康对照组比较差异有统计学意义(P<0.05),CKD各组间差异均有统计学意义(均P<0.05)。多元逐步回归分析显示,血浆NT-proBNP水平与LVEF呈负相关(P<0.05),与LVDd、LVDs、LVMI均呈正相关(均P<0.05)。结论CKD非透析患者血浆NT-proBNP水平随着肾功能的减退逐渐增高,和左室肥厚及心功能不全相关,提示NT-proBNP水平可作为一项评价CKD非透析患者左心功能的敏感生物学指标。
Objective To investigate plasma N-terminal pro-brain natriuretic peptede （NT-proBNP） levels and its relation to cardiac function in patients with pre-dialysis chronic kidney diseases （CKD）. Methods Plasma NT-proBNP concentrations were measured in 86 CKD patients and 30 healthy subjects. The CKD patients were divided into four group according to the glomerular filtration rate（GFR） by Cockcroft＇s formula： CKD I and II （n=8）, CKD III （n=26）, CKDIV（n=24）, and CKD V （n=28） groups. Plasma NT-proBNP, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVDd）, left ventricular end systolic diameter （LVDs） and left ventricular mass index （LVMI） were measured in patients and healthy controls. The relationship between BNP level and cardiac function was analyzed. Results The median plasma NT-proBNP concentrations increased with declining estimated GFR in CKD groups （P〈0.05）. Spearman correlation showed that the NT-proBNP level was positively correlated with LVDd, LVDs and LVMI, while negatively correlated with LVEF （all P〈0.05）. Conclusion The plasma NT-proBNP levels in non- dialysis patients with chronic kidney disease （CKD） are increased with declining of kidney function, which are correlated with left ventricular hypertrophy and cardiac insufficiency. The results suggest that plasma NT-proBNP may be used as a sensitive marker for monitoring the cardiac function in CKD patients.
出处
《浙江医学》
CAS
2015年第24期1998-2000,共3页
Zhejiang Medical Journal
基金
海盐县卫生系统科研项目(2014wsyb004)
