代谢综合征患者血浆氨基末端脑钠肽水平及其影响因素分析

Analysis of plasma n-terminal pro-brain natriuretic peptide levels and its influencing factors of patients with metabolic syndrome

目的：分析代谢综合征患者血浆NT?proBNP水平的影响因素。方法随机选取2012年4月至2015年4月开滦总医院收治的200例代谢综合征患者作为观察组，随机选取同期健康人群（非代谢综合征）200名作为对照组。对比两组患者血浆NT?proBNP水平。采用Pearson相关性分析和多元线性回归分析代谢综合征患者血浆NT?proBNP的影响因素。结果观察组和对照组患者的血浆NT?proBNP分别为（79．23±20．16） pg／L 与（102．25±27．26） pg／L，观察组明显低于对照组，差异有统计学意义（t＝4．154，P＜0．05）；Pearson相关性分析结果显示：血浆 NT?proBNP 水平与年龄、Cr、UA、主动脉根部内径（AOD）、左心室质量（LVM）、左心房内径（LAD）、左心室舒张末期内径（LVIDd）、舒张末期后壁厚度（LVPWd）呈正相关（r值分别为0．376、0．467、0．167、0．237、0．392、0．484、0．374、0．234，P均＜0．05），与BMI、TC、TG、LDL?C、Hb 及左心室射血分数（ LVEF ）呈负相关（ r 值分别为－0．167、－0．253、－0．187、－0．342、－0．354、－0．563，P均＜0．05），观察组多因素Logistic回归分析结果显示：年龄（ OR＝1．236，95％CI 1．072～2．726，P＜0．05）、BMI（OR＝2．256，95％CI 1．346～2．983，P＜0．05）、SBP（OR＝1．687，95％CI 1．183～3．209，P＜0．05）、DBP（OR＝1．125，95％CI 1．052～2．037，P＜0．05）、FPG（OR＝1．887，95％CI 1．495～3．494，P＜0．05）、TG（OR＝1．504，95％CI 1．256～2．609，P＜0．05）、LVMI（OR＝1．983，95％CI 1．363～2．574，P＜0．05）和EF（ OR＝1．485，95％CI 1．147～2．485，P＜0．05）是血浆NT?proBNP水平的独影响因素。结论代谢综合征患者血浆NT?proBNP 水平明显低于非代谢综合征患者，体质指数增大可能是重要原因。

Objective To analyze influence factors of the level of plasma n?terminal pro?brain natriuret?ic peptide( NT?proBNP ) in patients with metabolic syndrome. Methods Two hundred cases patients with the metabolic syndrome in KaiLuan General Hospital from April 2012 to April 2015 were randomly selected as the observation group, and 200 cases non?metabolic syndrome patients were randomly selected as the control group. The plasma NT?proBNP levels of the two groups were compared. Pearson correlation analysis and multiple linear regression analysis test were used to analyze the influence factors of the level of plasma NT?proBNP in pa?tients with metabolic syndrome. Results The level of plasma NT?proBNP of the observation group and the con?trol group were (79. 23±20. 16) pg/L and (102. 25±27. 26) pg/L respectively,the observation group was sig?nificantly lower than the control group,and the difference had statistical significance( t=4. 154,P<0. 05) . The pearson correlation analysis showed that in observation group the plasma NT?proBNP level were positively corre?lated with the age, Cr, UA, aortic root diameter ( AOD ) , left ventricular mass ( LVM ) , left atrium diameter (LAD), left ventricular end?diastolic diamete ( LVIDd), end?diastolic wall thickness after ( LVPWd) ( r=0. 376,0. 467,0. 167,0. 237,0. 392,0. 484,0. 374,0. 234; P<0. 05),and negatively correlated with BMI, TG,TC,LDL?C,Hb and left ventricular ejection fraction(LVEF) (r=-0. 167,-0. 253,-0. 187,-0. 342,-0. 354,-0. 563;P<0. 05). The multivariate Logistic regression analysis showed that in observation group,age (OR=1. 236,95%CI 1. 072-2. 726,P<0. 05),BMI(OR=2. 256,95%CI 1. 346-2. 983,P<0. 05),SBP(OR=1. 687,95%CI 1. 183-3. 209,P<0. 05),DBP(OR=1. 125,95%CI 1. 052-2. 037,P<0. 05),FPG(OR&nbsp;=1. 887,95%CI 1. 495-3. 494,P<0. 05),TG(OR=1. 504,95%CI 1. 256-2. 609,P<0. 05),LVMI(OR=1. 983,95%CI 1. 363-2. 574,P<0. 05) and LVEF(OR=1. 485,95%CI 1. 147-2. 485,P<0. 05) were inde?pendent factors affecting the level of plasma NT?proBNP. Conclusion The level of plasma NT?proBNP in pa?tients with metabolic syndrome is significantly lower than the patients without metabolic syndrome, the reason may be related to the increase in body mass index.