尿毒症维持性血液透析患者脑钠肽与干体重的相关性分析

Correlation between B-type natriuretic peptide and dry body weight in patients with uremic maintenance hemodialysis

目的分析尿毒症维持性血液透析(MHD)患者血浆脑钠肽(BNP)与干体重(△OH值)的相关性。方法选定解放军总医院第七医学中心于2020年12月至2022年12月就诊的80例尿毒症MHD患者研究,根据△OH值将患者分为两组,干体重达标患者设为干体重达标组(n=30),干体重未达标患者设为干体重未达标组(n=50),比较透析治疗前后血清BNP、△OH值,Pearson分析血清BNP与△OH值的相关性,使用受试者工作曲线(ROC)分析血清BNP对干体重达标的预测价值,统计MHD治疗相关并发症。结果患者透析后血清BNP、△OH值均低于透析前,差异有统计学意义(P<0.05)。干体重未达标组血清BNP水平高于干体重达标组,差异有统计学意义(P<0.05)。血清BNP与△OH值呈正相关性(r=0.359,P<0.05)。血清BNP对于干体重达标具有一定的预测价值(AUC=0.916,95%CI:0.848~0.955,P<0.05),灵敏度96.20%(95%CI:0.853~0.944,P<0.05)、特异度90.16%(95%CI:0.748~0.936,P<0.05)。治疗期间患者均病情平稳,无心血管事件发生,2例患者在透析中有血压偏低表现,予以停止超滤后自行好转,下机后无其他不适。结论尿毒症MHD患者血清BNP表达量与△OH值呈正相关性,临床可通过检测血清BNP表达量,提高对干体重达标的预测效能,从而指导临床针对性地展开治疗。

Objective To analyze the correlation between plasma B-type natriuretic peptide(BNP)and dry body weight(△OH value)in patients with uremic maintenance hemodialysis(MHD).Methods The patients with uremic MHD(n=80)were chosen from the First Medical Center,Chinese PLA General Hospital from Dec.2020 to Dec.2022,and were divided,according to△OH value,into compliance group(n=30)and non-compliance group(n=50).The level of BNP and△OH value were compared before and after treatment.The correlation between BNP and△OH value was analyzed by using Pearson correlation analysis.The predictive value of BNP to weight compliance was analyzed by using ROC curve.The relative complications treated with MHD were statistically counted.Results The level of BNP and△OH value were lower after treatment than before(P<0.05).The level of BNP was higher in non-compliance group than that in compliance group(P<0.05).The level of BNP was positively correlated to△OH value(r=0.359,P<0.05).The level of BNP had some predictive value to dry body weight compliance(AUC=0.916,95%CI:0.848~0.955,P<0.05),and sensitivity was 96.20%(95%CI:0.853~0.944,P<0.05)and specificity was 90.16%(95%CI:0.748~0.936,P<0.05).The condition was stable and no cardiovascular events occurred in all patients during treatment.There were 2 patients showed low blood pressure during dialysis,which was relieved spontaneously after stopping ultrafiltration without no other discomfort.Conclusion The level of BNP is positively correlated to△OH value in patients with uremic MHD.The predictive efficacy to dry body weight compliance can be improved through detecting BNP level to guide targeted treatment in clinical practice.