非心源性干扰因素对N端脑钠肽前体水平的影响及独立性分析

Analysis of the impact and independence of the effects of non-cardiac factors on the level of N-terminal pro-B-type natriuretic peptide

目的探究非心源性干扰因素对N端脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平影响的强弱及独立性,以明确哪些非心源性干扰因素需纳入NT-proBNP校正范围。方法回顾2019年2月—2019年6月江苏省人民医院肾内科及心血管内科的无心功能不全且未合并肺动脉高压、肺栓塞、肺水肿及败血症的住院患者231例。应用单因素二元Logistic回归分析筛选影响因素,配对t检验验证独立性,曲线回归分析寻找函数关系。结果单因素二元Logistic回归分析显示肥胖(OR=0.539,P=0.001,95%CI:0.373~0.779)、贫血(OR=5.419,P=0.000,95%CI:3.355~9.753)、肾功能不全(OR=2.603,P=0.000,95%CI:2.051~3.305)是NT-proBNP升高的危险因素。配对t检验结果显示,在通过配对去除另两个影响因素的情况下,只有肾功能不全独立影响NT-proBNP水平(不同的分组界限时P=0.000~0.001)。曲线拟合结果显示:NT-proBNP=5154.826eGFR^(-0.774)(R 2=0.409,P=0.000)。结论肾功能不全是NT-proBNP独立的强干扰因素,需纳入NT-proBNP校正范围。

Objective To explore the impact and independence of the effects of non-cardiac factors on the level of N-terminal pro-B-type natriuretic peptide(NT-proBNP),so as to determine which non-cardiac factors should be included in the correction range of NT-proBNP.Methods A retrospective study was carried out to investigate the clinical data from 231 patients in the renal department and the cardiovascular department of Jiangsu Province Hospital from February 2019 to June 2019.The patients had no cardiac insufficiency,nor combined with pulmonary hypertension,pulmonary embolism,pulmonary edema,and sepsis.Then,univariate binary logistic regression was performed to screen impact factors,while paired-samples t test was used to verify the independence of these factors,where the function was determined through curvilinear regression.Results Univariate binary logistic regression showed that obesity(OR=0.539,P=0.001,95%CI:0.373-0.779),anemia(OR=5.419,P=0.000,95%CI:3.355-9.753),and renal insufficiency(OR=2.603,P=0.000,95%CI:2.051-3.305)were the risk factors which caused the increase of NT-proBNP.Paired-samples t test showed that after eliminating the influence of the other two factors by pairing,renal insufficiency was the only factor which independently affected NT-proBNP(P=0.000-0.001 with different dividing standards).The result of curvilinear regression showed that NT-proBNP=5154.826eGFR^(-0.774)(R 2=0.409,P=0.000).Conclusions Renal function is an independent and strong interference factor of NT-proBNP which should be included in the correction range of NT-proBNP.