N-端脑钠肽与非心血管疾病血液透析患者死亡率的相关性研究

N-terminal pro-brain natriuretic peptide (NT-PROBNP) associated with mortality in non-CVD patients with hemodialysis:Prospectively study

目的探讨N-端脑钠肽(NT-PROBNP)与非CVD血液透析患者死亡率的关联性。方法选定628例透析患者进行登记,随访24个月,期间有87例患者死亡。用ROC曲线下面积来分析N-端脑钠肽与患者死亡的相关性。结果调整年龄、性别、血液透析年限、心胸比率(cardiothoracic ratio,CTR)、透析前收缩压平均值、干体重和基础肾病后,使用多变量Cox分析计算出N-端脑钠肽对数的危险比值(95%的置信区间):所有死亡原因3.83(2.51~5.85),CVD相关4.30(2.12~8.75),感染和恶性肿瘤相关2.41(1.17~4.93)和其他未知5.63(2.57~12.37)。结论N-端脑钠肽在普通的维持性血液透析患者人群中,与CVD相关患者的死亡率的关联具有显著性,与非CVD相关的患者死亡率也有一定关系。

Objective To explore the relationship of NT-PROBNP and 2-year mortality in non-CVD hemodialysis patients. Methods A prospectively observational study was taken. The 628 dialysis patients were enrolled in this study and followed for 24 months,when eighty-seven deaths were recorded. Area under the curve was used in analysis for NT-PROBNP. Results After adjusting for age,sex,hemodialysis vintage,cardiothoracic ratio,mean pre-dialysis systolic blood pressure,dry weight and basal kidney disease,the hazard ratios(95%confidence intervals) per 1-log NT-PROBNP were calculated using multivariate Cox analysis. All causes of death: 3.83(2.51-5.85);CVD-related:4.30(2.12-8.75);infection and malignancy-related:2.41(1.17-4.93) and others and unknown origin:5.63(2.57-12.37). Conclusion NT-PROBNP is significantly associated not only with the CVD-related but certainly with the non-CVD-related death of the maintenance hemodialysis patients.