肺部超声与人体成分分析在尿毒症腹膜透析患者容量负荷评估中的价值及与N末端脑钠肽前体的关系

Value of Pulmonary Ultrasound and Human Body Composition Analysis in Volume Load Assessment of Uremic Patients Undergoing Peritoneal Dialy⁃sis and Their Relationship with N⁃terminal Pro⁃brain Natriuretic Peptide

目的探究肺部超声与人体成分分析在尿毒症腹膜透析患者容量负荷评估中的价值,分析肺部超声、人体成分分析与血清N末端脑钠肽前体(NT-proBNP)的关系。方法选取2020年6月至2022年12月收治的50例尿毒症腹膜透析高容量负荷患者为观察组,另选50例尿毒症腹膜透析正常容量负荷患者为对照组。比较2组血压、心率及血生化指标,观察不良反应发生情况;比较2组肺部超声指标、人体成分指标,比较不同NT-proBNP水平患者肺部超声评分、干体质量差值,分析血清NT-proBNP与肺部超声评分、干体质量差值的关系。结果2组血压、心率及血生化指标比较,差异无统计学意义(P>005)。观察组不良反应总发生率32.00%(16/50)高于对照组14.00%(7/50,P<0.05)。入组时和3个月后,观察组A线数量少于对照组,B线数量多于对照组,肺部超声评分、水负荷、水肿指数、干体质量差值高于对照组(P<0.05)。透析前,观察组血清NT-proBNP水平高于对照组(P<0.05)。入组时和3个月后,高NT-proBNP亚组肺部超声评分、干体质量差值均高于低NT-proBNP亚组(P<0.05)。经Spearman相关系数法分析,尿毒症腹膜透析患者血清NT-proBNP与干体质量差值、肺部超声评分均呈正相关(P<0.05)。结论肺部超声与人体成分分析均可评估尿毒症腹膜透析患者容量负荷,高容量负荷患者血清NT-proBNP水平异常升高,且与肺部超声评分、干体质量差值关系密切,肺部超声、人体成分分析可有效指导患者的诊疗方案制订,以改善预后,具有一定的临床应用价值。

Objective To explore the value of pulmonary ultrasound and human body composition analysis in volume load assessment of uremic patients undergoing peritoneal dialysis,and to analyze the relationship between pulmonary ultra-sound,human body composition analysis,and serum N-terminal pro-brain natriuretic peptide(NT-proBNP).Methods A total of 50 patients with high volume load in uremia undergoing peritoneal dialysis from June 2020 to December 2022 were se-lected as the observation group,and another 50 patients with normal volume load undergoing peritoneal dialysis were selected as the control group.The blood pressure,heart rate and blood biochemical indexes of the two groups were compared,and the occurrence of adverse reactions was observed.The lung ultrasound indexes and human body composition indexes of the two groups were compared,the lung ultrasound scores and dry body mass difference values of patients with different NT-proBNP levels were compared,and the relationship of serum NT-proBNP with lung ultrasound scores and dry body mass difference val-ues was analyzed.Results There was no significant difference in blood pressure,heart rate and blood biochemical indicators between the two groups(P>005).The total incidence of adverse reactions in the observation group was 32.00%(16/50),which was higher than that in the control group,with an incidence of 14.00%(7/50,P<0.05).At the time of enrollment and 3 months after enrollment,the number of A-lines in the observation group was smaller than that in the control group,while the number of B-lines was larger,and lung ultrasound score,water load,edema index,and dry body mass difference were higher than those in the control group(P<0.05).Before hemodialysis,the serum NT proBNP levels in the observation group were higher than those in the control group(P<0..05).At the time of enrollment and 3 months after enrollment,the pulmo-nary ultrasound scores and dry body mass differences in the high NT-proBNP subgroup were higher than those in the low NT-proBNP subgroup(P<0.05).According to the Spearman correlation coefficient analysis,serum NT-proBNP in uremic pa-tients undergoing peritoneal dialysis was positively correlated with dry body mass difference and lung ultrasound scores(P<0.05).Conclusion Both lung ultrasound and human body composition analysis can assess the volume load in patients with uremia undergoing peritoneal dialysis.Patients with high volume load have abnormally elevated serum NT-proBNP levels,which are closely related to lung ultrasound scores and dry body mass differences.Lung ultrasound and body composition anal-ysis can effectively guide the development of treatment plans for patients,improve prognosis,and have certain clinical applica-tion value.