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