老年血液透析患者NT-proBNP水平在干体重评估中的临床意义

Clinical significance of NT-proBNP level in elderly hemodialysis patients in dry weight evaluation

目的研究老年血液透析患者氨基末端B型脑钠尿肽水平在干体重评估中的临床意义。方法选取40例于2016年6月~2018年6月在我院行维持血液透析的干体重超标的老年患者,并选取同一时期的30例健康体检者作为对照组。所有患者在两周透析脱水达到临床干体重,测定观察组患者体重下调前后血浆NT-proBNP浓度、心胸比值及体重,同时观察体重下调前后患者的临床表现并记录。结果体重下调前血浆NT-proBNP浓度、心胸比值及体重与体重下调后比较,差异有统计学意义(P<0.05);体重下调后血浆NT-proBNP浓度与对照组比较,差异有统计学意义(P<0.05),但心胸比值和体重与对照组比较,差异均无统计学意义(P>0.05);体重下调前、后NT-proBNP之差与心胸比之差呈正相关(r=0.58,P<0.01)。结论NT-proBNP可作为评估老年血液透析患者干体重较好的指标,较传统指标更具敏感性、便捷性。

Objective To study the clinical significance of N-terminal B-type natriuretic peptide(NT-proBNP)levels in elderly hemodialysis patients in the evaluation of dry weight.Methods Forty elderly maintenance hemodialysis patients with excessive dry weight in our hospital between June 2016 and June 2018 were selected as the study group.Thirty healthy people who underwent the physical examination in the same period were selected as the control group.All patients reached clinical dry weight after two weeks of dialysis and dehydration.Plasma NTproBNP concentration,cardiothoracic ratio,and body weight were measured before and after weight reduction in the observation group.The clinical manifestations of patients before and after weight reduction were recorded.Results The differences of plasma NT-proBNP concentration,cardiothoracic ratio,and body weight before and after weight reduction were statistically significant(P<0.05);After weight reduction,plasma NT-proBNP concentration was significantly different from the control group,but cardiothoracic ratio and body weight were not significantly different from the control group(P>0.05);The difference of NT-proBNP before and after weight reduction was positively correlated with the difference between cardiothoracic ratio(r=0.58,P<0.01).Conclusion NT-proBNP can be used as a better indicator in evaluating dry weight in elderly hemodialysis patients,and it is more sensitive and convenient than traditional indicators.