慢性肾脏病血B型利钠肽水平与心脏结构及功能的关系

Relationship between plasma BNP and cardiac structure and function in patients with chronic kidney disease

目的探讨慢性肾脏病（CKD）非透析患者血B型利钠肽水平（BNP）与心脏结构及功能的关系。方法选取96例CKD3～5期非透析患者为研究对象，另选20例年龄、性别匹配的健康体检者为对照；清晨空腹取血检测BNP，并行超声心动图检查。结果与对照组相比，CKD各期血BNP浓度均增高（P均〈0．01）；且随着CKD进展，BNP水平呈逐渐增加趋势；相关分析显示血BNP浓度与左心室心肌质量指数（LMVI）（r=0．502，P〈0．01）及左心室舒张末内径（LVEDd）（r=0．384，P〈0．01）呈正相关，与心脏射血分数（EF）呈负相关（r=-0．593，P〈0．01）。结论CKD患者血BNP浓度随CKD进展而升高，BNP水平对CKD患者心室结构改变及EF下降有预测价值。

Objective To investigate the relationship between B type natriuretic peptide （BNP） and cardiac structure and function in patients with chronic kidney disease （CKD）. Methods A total of 96 CKD patients （K/DOQI stage 3-5） were enrolled in this study and 20 healthy were enrolled as control. Echocardiography was used to evaluate the state of cardiac structure and function. Plasma BNP was determined by means of enzyme-linked immunosorbent assay （ELISA）. Results Plasma BNP were higher in all CKD patients than those in control subjects （P〈0.01）, and BNP rises proportionally with the decline of renal function. Plasma BNP was positively correlated with LMVI （r=0.502, P〈0.01） and LVEDd （r=0.384, P〈0.01）. Plasma BNP was also negatively correlated with LVEF （r=-0.593, P〈0,01）. Conclusion Plasma BNP rises proportionally to the decline of renal function. There were an association between plasma BNP and cardiac structure and function in CKD patients, and it is likely that BNP could be a useful marker for prediction of changes of ventricular structure and function in CKD patients,