血浆N-末端脑利钠肽与慢性肾脏病非透析患者合并心力衰竭相关性分析

The Correlation of Plasma N-terminal Pro-brain Natriuretic Peptide and Non-dialysis Patients with Chronic Kidney Disease Complicated with Heart Failure

目的探讨血浆N-末端脑利钠肽(NT-proBNP)与慢性肾脏病(CKD)非透析患者心力衰竭的关系。方法选择CKD非透析患者132例,按照NYHA心功能分级分为:Ⅰ级组40例,Ⅱ级组34例,Ⅲ级组30例,Ⅳ级组28例。另外选择健康体检者40例作为对照组。分别采用电化学发光法测定血浆NT-proBNP水平,心脏超声测定心脏左室射血分数(LVEF),全自动生化仪检测血肌酐、尿素氮等。结果从健康对照组到CKD患者不同心功能组(Ⅰ至Ⅳ),LVEF逐级递减,NT-proBNP水平逐级递增,各组间比较差异均有统计学意义(P均<0.01)。且CKD患者心功能Ⅰ级组的LVEF显著低于健康对照组,NT-proBNP显著高于健康对照组。不同NYHA心功能分级患者的LVEF随心功能级别增加而显著降低,血浆NT-proBNP浓度随心功能级别增加而显著升高。结论 CKD非透析患者NT-proBNP水平与心功能、肾功能相关,NT-proBNP水平可作为一项评价CKD非透析患者心功能分级的参考指标之一,值得临床推广。

Objective To explore the relationship between plasma N-terminal pro-brain natriuretic peptide （ NT-proBNP ） and chronic kidney disease （ CKD ） in patients with heart failure without dialysis. Methods There were 132 CKD non-dialysis patients and were divided according to NYHA functional class： Ⅰ level group of 40 patients, Ⅱgrade group of 34 cases,Ⅲ grade group of 30 cases, Ⅳ -level group of 28 cases. Another 40 cases were selected as healthy control group. Determined NT-proBNP levels were by electrochemiluminescence plasma, left ventricular ejection fraction （ LVEF ） by echocardiographic determination, serum creatinine, urea nitrogen by automatic biochemical analyzer. Results LVEF progressively decreased, NT-proBNP level of incremental, from the healthy control group to the CKD patients with different cardiac function group （ I to IV ）, the groups were statistically significant differences between （ all P 〈 0.01 ）. And LVEF of cardiac function in patients with CKD class Ⅰ group was significantly lower than the control group, NT-proBNP was significantly higher than in the healthy control group. LVEF of different NYHA functional class level of cardiac function were significantly decreased and plasma NT-proBNP concentrations were significantly increased with level of increase in cardiac function. Conclusion NT-proBNP level of CKD non-dialys.is patients related to heart function, kidney function, NT- proBNP levels can be used as an evaluation of cardiac function in patients with CKD non-dialysis reference classification, worthy to be popularized.