摘要
目的:研究血肌钙蛋白I(TnI)、超敏C-反应蛋白(hs-CRP)、N末端脑钠肽原(NT-proBNP)在诊断尿毒症患者心肌损害的临床意义。方法:选取2017年1月~2019年2月在本院治疗的尿毒症患者共114例作为研究对象,根据患者是否发生心肌损害分为两组,尿毒症组(63例)和尿毒症心肌损害组(51例)。选取同期在本院住院的非慢性肾病、非心血管疾病的50例患者作为对照组。分别检测并比较各组患者入院后第1、3、7天的TnI、hs-CRP、NT-proBNP水平;同时记录并比较入院后的心超指标左室射血分数(LVEF)、左室后壁厚度(LVPWd)。利用Person correlation相关性分析患者入院后TnI、hs-CRP、NT-proBNP水平与心超指标LVEF、LVPWd的相关性。构建COX回归分析模型分析影响尿毒症患者临床预后的独立危险因素。结果:各组TnI、hs-CRP、NT-proBNP水平在入院后第1、3、7天均具有明显差异,且随着治疗,尿毒症心肌损害组及尿毒症组TnI、hs-CRP、NT-proBNP均降低,其中尿毒症心肌损害组TnI、hs-CRP、NT-proBNP最高(P<0.05)。尿毒症心肌损害组LVEF与其他两组相比最低,而LVPWd最厚,差异均具有统计学意义(P<0.05)。LVEF与TnI、hs-CRP、NT-proBNP水平呈负相关;LVPWd与TnI、hs-CRP、NT-proBNP水平呈正相关(P<0.05)。COX回归分析结果表明,TnI、hs-CRP、NT-proBNP、LVEF、LVPWd是影响尿毒症患者临床预后的独立危险因素。结论:TnI、hs-CRP、NT-proBNP在尿毒症合并心肌损害患者的发病及治疗过程中处于动态变化过程,可用于早期诊断尿毒症合并心肌损害。
Objective:To study the clinical significance of troponinI(TnI),high sensitivity C reactive protein(hs-CRP)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the diagnosis of myocardial damage in uremia patients.Methods:A total of 114 uremia patients treated in the hospital from January 2017 to February 2019 were selected.According to whether myocardial damage occurred,patients were divided into two groups including uremia group(63 cases)anduremia myocardial damage group(51 cases).Totally 50 hospitalized patients with non-chronic kidney disease and non-cardiovascular disease were selected as control group.The levels of TnI,hs-CRP and NT-proBNP on day 1,3 and 7 after admission were detected and compared.Meanwhile,the ecg indexes of left ventricular ejection fraction(LVEF)and thickness of the posterior wall of the left ventricle(LVPWd)were recorded and compared.Person correlation was used to analyze the correlation between the levels of TnI,hs-CRP,NT-proBNP and ecg indexes including LVEF and LVPWd.COX regression analysis was used to analyze the independent risk factors affecting the clinical prognosis of uremia patients.Results:The levels of TnI,hs-CRP,NT-proBNP in the three groups were significantly different on day 1,3,7 after admission.The levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group and uremia group were decreased with treatment.However,the levels of the three indexes(TnI,hs-CRP,NT-proBNP)in uremia combined with myocardial damage group were the highest(P<0.05).Compared with the other two groups,the LVEF of uremia combined with myocardial damage group was the lowest,while the LVPWd was the thickest,showing a significant difference(P<0.05).There was negative correlation between LVEF and TnI,hs-CRP,NT-proBNP levels.However,LVPWd was positively correlated with TnI,hs-CRP and NT-proBNP levels(P<0.05).COX regression analysis showed that TnI,hs-CRP,NT-proBNP levels,LVEF and LVPWd were the independent factors affecting the clinical prognosis of uremia patients.C
作者
姚娬斌
沈良兰
沈燕
黄华星
YAO Wu-bin;SHEN Liang-lan;SHEN Yan;HUANG Hua-xing(Department of Renal Medicine, Nantong First People's Hospital, Nantong, Jiangsu 226001, China)
出处
《海南医学院学报》
CAS
2020年第16期1232-1236,共5页
Journal of Hainan Medical University
基金
南通市卫生和计划生育委员会科研项目(MB2019009)
南通市科技计划项目(MSZ18258)。
