摘要
目的探讨慢性肾脏疾病(CKD)患者N末端脑利钠肽前体(NT-proBNP)水平及在评价CKD患者心功能中的价值。方法收集2013年1月至2014年12月以慢性肾脏相关疾病为主诊的住院患者567例,按其估算肾小球滤过率分为6组,结合患者心功能分级,分析其血浆NT-proBNP水平与肾功能、心功能的相关性以及CKD患者诊断心功能衰竭的截断值。结果 CKD患者心功能越差,血浆NT-proBNP质量浓度越高;估算肾小球滤过率越低,血浆NT-proBNP质量浓度越高,且两者间呈负相关(r=-0.529,P<0.01);通过绘制受试者工作特征曲线(ROC曲线),在CKD不同分期的患者中诊断心功能衰竭的NT-proBNP界值分别为G1:119.5ng/L,G2:168.5ng/L,G3a:300.5ng/L,G3b:1 019.5ng/L,G4:2 777.5ng/L,G5:3 640.5ng/L。结论血浆NT-proBNP水平受肾脏功能影响,与估算肾小球滤过率存在负相关,建议对CKD患者应用NT-proBNP进行心脏功能评估时,应考虑采用不同的界断值。
Objective To determine the plasma level of N-terminal brain natriuretic peptide precursor （NT- proBNP） in patients with chronic kidney disease （CKD） and its association with cardiac function, Methods A total of 567 CKD patients admitted to the hospital from January 2013 to December 2014 were divided into six groups according to their estimated glomerular filtration rate. Their plasma level of NT-proBNP, renal function, and cardiac function were determined. Results The worse patients cardiac function, and the lower eGFR, the higher concentration of plasma NT-proBNP. Plasma level of NT-proBNP was negatively correlated with glomerular filtration rate （X2=0. 529, P〈0.01）. The receiver operating characteristic curves generated a Cutoff NT-proBNP value of 119.5 ng/L, 168.5 ng/L, 300.5 ng/L, 1 019.5 ng/L, 2 777.5 ng/L, and 3 640.5 ng/L, respectively, for diagnosing cardiac failure in the six groups, respectively. Conclusion NT-proBNP is affected by renal function, which can he used for diagnosing cardiac failure in patients with CKD.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2017年第4期561-565,共5页
Journal of Sichuan University(Medical Sciences)
基金
四川省卫生和计划生育委员会科研课题(No.17PJ520)资助
关键词
慢性肾脏病
N末端脑利钠肽前体
心功能评估
Chronic kidney disease N-terminal brain natriuretic peptide precursor Cardiac function
