慢性肾脏病患者血浆氨基末端前体脑钠肽与心功能的关系

Relationship of plasma N-terminal pro-brain natriuretic peptide and cardiac function in patients with chronic kidney disease

目的研究血浆氨基末端前体脑钠肽(NT-proBNP)与心功能的关系。方法采用固相免疫层析法检测152例不同分期慢性肾脏病(CKD)组患者与20例对照组血浆NT-proBNP水平,分析其与心脏彩超各指标、生化指标的关系。结果伴有心衰的各期CKD患者NT-proBNP水平远高于同一分期无心衰患者;非心衰组CKD患者的NT-proBNP水平随着肾小球滤过率的下降逐渐升高;NT-proBNP水平与左房内径以及左室舒张末内径、左室收缩末内径均呈正相关,与心脏射血分数呈负相关。结论 NT-proBNP是早期诊断CKD患者无症状性心功能不全的敏感指标。

Objective To study the relationship of plasma N-terminal pro-brain natriuretic peptide（NT-proBNP） and cardiac function in patients with chronic kidney disease（CKD）.MethodsPlasma NT-proBNP was examined in 152 CKD patients and 20 healthy subjects.The relationship of plasma NT-proBNP and echocardiographic and biochemistry parameter was analyzed.Results Plasma NT-proBNP level of CKD patients with heart failure was much higher than that of CKD cases in same stage but without heart failure.Plasma NT-proBNP level of CKD patients without heart failure increased with the decrease of the level of estimated glomerular filtration rate（eGFR）,which was not in CKD patients with heart failure.NT-proBNP level was positively correlated with left atrial diameter（LAD）,left ventricular end-diastolic diameter（LVEDD） and left ventricular end-systolic diameter（LVESD）,but negatively correlated with left ventricular ejection frection（LVEF）.Conclusion Plasma NT-proBNP is a sensitive marker for diagnosing early symptomless heart failure in CKD patients.