NT-ProBNP测定在妊娠糖尿病肾损伤中变化及临床诊断价值

Change of NT-ProBNP detection in gestational diabetes mellitus with renal injury and its clinical diagnose value

目的：探讨氨基末端B型利钠肽前体（NT-ProBNP）在妊娠糖尿病肾损伤患者中的变化及其临床诊断价值.方法：选取妊娠性糖尿病患者（GDM组）75例,健康妊娠孕妇（健康对照组）55例,根据尿白蛋白排泄率（UAER）,依照Mogensen分期将GDM患者分为单纯GDM组、早期肾病组及临床肾病组,分别检测各组血清NT-ProBNP、 胱抑素C（CysC）、 肌酐（Cr）及尿微量白蛋白（mALB）水平,并对结果进行分析,同时用Pearson相关分析分析NT-ProBNP与CysC、Cr及mALB的向相关性.结果：结果显示GDM组血清NT-ProBNP、CysC、Cr及mALB水平显著高于健康对照组（P〈0.05）,并且NT-ProBNP从单纯GDM组、 早期肾病组及临床肾病组逐渐升高,差异具有统计学意义（P〈0.05）.Pearson相关性分析显示,NT-ProBNP与CysC、Cr及mALB成正相关（P〈0.05）.结论：NT-ProBNP在妊娠糖尿病患者血清明显升高,与其微血管病变有关,可作为诊断妊娠糖尿病肾病和评估其肾脏损伤程度的指标.

Objective： To observe the change of N-terminal pro-brain natriuretic peptide levels in gestational diabetes mellitus and to investigate its clinical significance in patients with gestational diabetes mellitus. Methods： 60 cases with gestational diabetes mellitus （GDM） and 40 normal pregnant women （health control group） were enrolled. According to the urinary albumin excretion rate （UAER） , GDM patients were divided into pure GDM group, the early nephropathy group and c）inical kidney disease group in accordance with Mogensen staging. Surem HE, NT-ProBNP, CysC, Cr and urine trace albumin （mALB） levels in different groups were tested, and the results were analyzed. At the same time, the correlations of N-terminal pro-brain natriuretic peptide with CysC, Cr and urine trace albumin （mALB） were analyzed by Pearson correlation analysis. Results： The levels of NT-ProBNP, CysC, Cr and urine mALB were significantly higher in GDM patients than those in healthy controls （P〈0.05） . The results showed that N-terminal pro-brain natriuretic peptide levels in pure GDM group, the early nephropathy group and clinical kidney disease group were gradually increased, the difference is statistically significant （P〈0.05） . Pearson correlation analysis revealed that N-terminal pro-brain natriuretic peptide was positively correlated with CysC, Cr and urine trace albumin （mALB） （all P〈0.05） . Conclusion： The level of NT-ProBNP increased significantly in patients with gestational diabetes mellitus. NT-ProBNP may correlate with diabetic microangiopathy, which can be used as reliable clinical marker for assessing the severity and diagnosis of diabetic nephropathy.