动态检测BNP、AOPPs在CRRT治疗脓毒症急性肾损伤并发心力衰竭患者死亡的相关性研究

The correlation study of dynamic detection of BNP combined with AOPPs in CRRT treatment of sepsis acute kidney injury complicated with heart failure patients

目的探讨动态检测B型钠尿肽(BNP)、晚期氧化蛋白产物(AOPPs)在连续性肾脏替代疗法(CRRT)治疗脓毒症急性肾损伤并发心力衰竭患者死亡的相关性。方法选取2020年7月-2021年12月南宁市第二人民医院肾内科收治的行CRRT治疗且动态检测BNP、AOPPs的脓毒症急性肾损伤患者90例,分为合并心力衰竭和非心力衰竭组,各45例,依据患者出院后5个月内是否生存分为生存组和死亡组。对比分析不同患者BNP、AOPPs水平,并分析BNP、AOPPs水平与脓毒症急性肾损伤并发心衰患者死亡的相关性。结果治疗前心力衰竭组患者BNP水平、AOPPs水平显著高于非心力衰竭组(P<0.05);治疗3 d、7 d后,2组BNP、AOPPs均降低,但心力衰竭组患者BNP、AOPPs水平依然显著高于非心力衰竭组(P<0.05)。患者出院后5个月内死亡42例,生存48例,死亡组BNP、AOPPs水平均显著高于生存组,差异有统计学意义(P<0.05)。通过Logistic回归分析,结果发现BNP、AOPPs均是脓毒症急性肾损伤合并心力衰竭患者死亡的独立危险因素,且存在正相关性(P<0.05)。结论BNP、AOPPs水平增高与脓毒症急性肾损伤并发心力衰竭患者的死亡存在正相关性,通过检测其水平可辅助了解CRRT治疗患者的病情发展趋势。

Objective To investigate the correlation of dynamic detection of B-type natriuretic peptide(BNP)combined with advanced oxidized protein products(AOPPs)in continuous renal replacement therapy(CRRT)treatment of sepsis acute kidney injury complicated with heart failure patients.MethodsFrom July 2020 to December 2021,90 patients with sepsis acute kidney injury treated by dynamic detection of BNP combined with AOPPs in the Department of Nephrology of Nanning Second People's Hospital were retrospectively selected.According to imaging examination,patients were divided into combined heart failure group and non-heart failure group,45 cases in each group.According to whether the patients survived within 5 months after discharge,they were divided into survival group and death group.The levels of BNP and AOPPs in different patients were compared and analyzed,and the correlation between the levels of BNP and AOPPs and the death of patients with sepsis acute kidney injury complicated with heart failure was analyzed.ResultsBefore treatment,the levels of BNP and AOPPs in the heart failure group were significantly higher than those in the non-heart failure group(P<0.05);After 3 and 7 days of treatment,BNP and AOPPs in both groups were decreased,but the levels of BNP and AOPPs in the heart failure group were still significantly higher than those in the non-heart failure group(P<0.05);42 patients died within 5 months after discharge,and 48 survived.The levels of BNP and AOPPs in the death group were significantly higher than those in the survival group,and the difference was statistically significant(P<0.05);through logistic regression analysis,it was found that BNP and AOPPs were independent risk factors for death in patients with sepsis acute kidney injury complicated with heart failure,and there was a positive correlation(P<0.05).Conclusion The increased levels of BNP and AOPPs are positively correlated with the death of patients with sepsis acute kidney injury complicated with heart failure.The detection of BNP and AOPPs levels can help to understand the development trend of the disease in patients treated with CRRT.