持续非卧床腹膜透析患者左心室肥厚与血清N-末端脑钠素原水平的关系

Relationship between left ventricular hypertrophy and serum level of N-terminal pro-brain natriuretic peptide in patients undergoing continuous ambulatory peritoneal dialysis

目的探讨持续非卧床腹膜透析(CAPD)患者左心室肥厚(LVH)与血清N-末端脑钠素原(NT-proBNP)水平的关系。方法连续入选32例接受CAPD治疗1年以上患者,超声心动图检查测算左心室心肌质量指数(LVMI);根据LVMI将入选者分为左心室肥厚组和左心室正常组,双抗体夹心酶标免疫法测定两组患者血清NT-proBNP水平。结果入选CAPD患者中,左心室肥厚组17例,左心室正常组15例,左心室肥厚组血清NT-proBNP(6234.21±854.43)pg/ml较左心室正常组血清NT-proBNP(2456.23±576.98)pg/ml水平明显升高(P<0.01),且NT-proBNP水平与LVMI呈正相关(r=0.625,P<0.01),NT-proBNP诊断LVH的ROC曲线下面积为0.912。结论 CAPD合并LVH患者血清NT-proBNP水平明显升高,与LVMI呈正相关且有诊断价值,NT-proBNP可能是预测CAPD患者合并LVH的一个新指标。

Objective To elucidate the relationship between left ventricular hypertrophy（LVH）and serum level of N-terminal pro-brain natriuretic peptide（NT-proBNP）in patients undergoing continuous ambulatory peritoneal dialysis（CAPD）.Methods Thirty-two patients undergoing CAPD for over 12 months were included in this study.Transthoracic echocardiography was performed and left ventricular mass index（LVMI）was calculated.They were divided into LVH group and normal left ventricular group according to LVMI and their serum level of NT-proBNP was measured by ELISA.Results 17 of 32 patients undergoing CAPD had LVH and 15 cases were normal on the basis of LVMI.The serum level of NT-proBNP in patients with LVH was significantly higher than those without LVH[（6234.21±854.43）pg/ml vs.（2456.23±576.98）pg/ml,P0.01].Furthermore,LVMI had a positive correlation with NT-proBNP（r=0.625,P0.01）.The area under ROC curve of NT-proBNP was 0.912.Conclusion Patients with LVH undergoing CAPD shows a significant increase in the serum level of NT-proBNP which is positively correlated with LVMI.Therefore,NT-proBNP may be a new marker to predict LVH in patients undergoing CAPD.