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血浆脑钠肽与慢性肾脏病患者动脉粥样硬化及血压昼夜节律的相关性

The relationship of BNP with arteriosclerosis and ambulatory blood pressure measurement in patients with chronic kidney disease
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摘要 目的研究脑钠肽(BNP)与慢性肾脏病(CKD)患者动脉粥样硬化及血压昼夜节律异常的关系。方法采用免疫荧光法检测108例CKD患者与18例对照组血浆脑钠肽(BNP)水平,动态血压监测(ABPM)采用携带式的动态血压检测仪。分析BNP水平与动脉粥样硬化及血压昼夜节律的关系。结果CKD患者BNP水平与对照组相比显著升高(P<0.01),Spearman相关分析提示CKD患者BNP水平和颈动脉内膜中层厚度(IMT)呈正相关,存在颈动脉斑块的患者血BNP水平显著升高。与对照组相比,CKD患者夜间收缩压和舒张压下降数值较小,血压呈明显的非勺型模式;血压昼夜节律异常的患者血BNP水平显著升高(P<0.01)。多元回归分析显示,动脉粥样硬化和血压昼夜节律异常均是影响BNP水平的危险因素。结论CKD患者BNP水平和动脉粥样硬化及血压昼夜节律异常相关,提示BNP水平可作为一项评价CKD患者动脉粥样硬化及血压节律异常的生物学指标。 Objective To clarify the association of brain natriuretic peptide (BNP) with arterio- sclerosis and abnormality of circadiam rhythm in chronic kidney disease. Methods Fluorescence im- mune-assay was used to detect the blood plasma BNP in a cohort of 108 CKD patients and 18 hyperten- sive controls. Ambulatory blood pressure monitoring (ABPM) was performed with a portable oscillo- metric recorder (CB-1804-B) ,WABP180B software was used to analyze the 24-hour data. The rela- tionship of BNP with arteriosclerosis and circadian rhythm of blood pressure. Results BNP level was sig- nificantly higher in CKD patients than that in control subjects [157.50 (135.00-200. 00) pg/ml vs 602.00 (389. 68-915.50) pg/ml,P〈0.01]. Spearman correlation showed that the BNP level was positively correlated with carotid intima-media thickness(IMT). BNP concentration was significantly higher in patients with carotid plaques. The CKD group revealed a much less pronounced decline in nocturnal mean BP values,CKD patients displayed pronounced abnormalities in the 24-hour BP pattern,with markedly blunted nocturnal fall and flattened or reversed day-night circadian rhythm BP values. BNP level was greater in the patients with abnormality of circadian rhythm(P〈0.01 ). Multiple regression analysis showed that arteriosclerosis and ab- normality of circadian rhythm were the determinant of BNP. Conclusion BNP level is significantly correla-ted with arteriosclerosis and obnormality of circadian rhythm. BNP may be a sensitive biomarker for the evaluation of arteriosclerosis and obnormality of circadiam rhythm in CKD patients.
出处 《贵州医药》 CAS 2013年第10期874-878,共5页 Guizhou Medical Journal
基金 贵阳市科技局社会发展与民生科技计划基金资助项目[筑科合(2011)10 321号]
关键词 脑钠肽 慢性肾脏病 动脉粥样硬化 动态血压监测 Brain natriuretic peptide Chronic kidney disease Arteriosclerosis Ambula- tory blood pressure monitoring
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