摘要
目的探讨青中年血液透析合并心力衰竭患者血清嗜铬粒蛋白A(CGA)与B型脑钠尿肽(BNP)和心功能分级的关系。方法选择2016年8月至2018年11月大连大学附属中山医院治疗的青中年血液透析患者78例,根据美国纽约心脏病学会的心功能分级(NYHA)分为心功能Ⅰ级组19例,心功能Ⅱ级组21例,心功能Ⅲ级组18例,心功能Ⅳ级组20例,选择同期在本院体检的健康者20例作为对照组,检测所有受检者的血清CGA、BNP水平,并行心脏彩色超声检查,测量左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)等相关指标。结果对照组和心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组患者的CGA水平分别为(39.13±8.27)μg/L、(73.84±9.62)μg/L、(97.28±13.61)μg/L、(123.21±16.23)μg/L、(158.62±18.47)μg/L,BNP水平分别为(35.26±10.32)ng/L、(71.26±11.75)ng/L、(91.47±15.31)ng/L、(131.26±21.67)ng/L、(172.19±23.73)ng/L,差异均有显著统计学意义(P<0.01);对照组和心功能Ⅰ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组患者的心脏超声指标LVEF分别为(62.17±5.28)%、(60.41±8.63)%、(55.72±6.86)%、(46.69±5.42)%、(40.37±5.18)%,LVEDD分别为(44.52±2.48)mm、(49.42±3.87)mm、(52.27±3.58)mm、(56.71±4.32)mm、(59.45±5.51)mm,LVESD分别为(27.63±2.36)mm、(31.73±2.61)mm、(33.79±3.74)mm、(35.85±3.95)mm、(37.69±4.71)mm,LAD分别为(39.31±3.27)mm、(43.58±3.79)mm、(47.63±4.58)mm、(50.29±5.63)mm、(53.44±6.51)mm,差异均具有统计学意义(P<0.05);相关性分析结果显示,血清CGA与LVEF呈负相关(r=-0.741),CGA与LVEDD、LVESD和LAD呈正相关(r=0.632、0.696、0.654),血清BNP与LVEF呈负相关(r=-0.706),BNP与LVEDD、LVESD和LAD呈正相关(r=0.641、0.682、0.663)。结论检测CGA和BNP水平有助于判断青中年血液透析合并慢性心力衰竭患者心力衰竭的严重程度。
Objective To investigate relationship between serum chromogranin A(CGA)and B-type brain natriuretic peptide(BNP)and cardiac function classification in young and middle-aged patients with hemodialysis and heart failure.Methods A total of 78 young and middle-aged patients with chronic renal failure treated in Hemodialysis Center of Zhongshan Hospital Affiliated to Dalian University from August 2016 to November 2018 were selected.According to New York Heart Association(NYHA),the patients were divided into the cardiac function classⅠgroup(n=19),cardiac function classⅡgroup(n=21),cardiac function classⅢgroup(n=18)and cardiac function classⅣgroup(n=20).Another 20 healthy persons were selected in the same period(control group).Serum CGA and BNP levels were measured,and left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),and left atrial diameter(LAD)were measured by echocardiography.Results The CGA levels of the control group and cardiac functionⅠ,Ⅱ,ⅢandⅣgroups were(39.13±8.27)μg/L,(73.84±9.62)μg/L,(97.28±13.61)μg/L,(123.21±16.23)μg/L,(158.62±18.47)μg/L,respectively;BNP levels of the five groups were(35.26±10.32)ng/L,(71.26±11.75)ng/L,(91.47±15.31)ng/L,(131.26±21.67)ng/L,(172.19±23.73)ng/L,respectively;there were also significant differences among groups(P<0.01).The LVEF of the control group and cardiac functionⅠ,Ⅱ,ⅢandⅣgroups were(62.17±5.28)%,(60.41±8.63)%,(55.72±6.86)%,(46.69±5.42)%,(40.37±5.18)%;LVEDD of the five groups were(44.52±2.48)mm,(49.42±3.87)mm,(52.27±3.58)mm,(56.71±4.32)mm,(59.45±5.51)mm,respectively;LVESD were(27.63±2.36)mm,(31.73±2.61)mm,(33.79±3.74)mm,(35.85±3.95)mm,(37.69±4.71)mm,respectively;LAD were(39.31±3.27)mm,(43.58±3.79)mm,(47.63±4.58)mm,(50.29±5.63)mm,(53.44±6.51)mm,respectively;there were significant differences among the five groups(P<0.05).The correlation analysis showed that serum CGA was negatively correlated with LVEF(r=-0.741),and CGA was positively correlated with LVEDD,LVESD and LAD(r=0.6
作者
邓承慧
张宇
DENG Cheng-hui;ZHANG Yu(Department of Nephrology,the Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning,CHINA;Department of Liver Diseases,Dalian Sixth People's Hospital,Dalian 116001,Liaoning,CHINA)
出处
《海南医学》
CAS
2019年第16期2051-2054,共4页
Hainan Medical Journal
关键词
青中年
血液透析
心力衰竭
嗜铬粒蛋白
B型脑钠尿肽
心功能分级
Young and middle-aged
Hemodialysis
Heart failure
Chromogranin
B-type brain natriuretic peptide(BNP)
Cardiac function classification
