血浆N-末端脑利钠肽及慢性肾脏病非透析患者合并心力衰竭相关性研究.docVIP

血浆N-末端脑利钠肽及慢性肾脏病非透析患者合并心力衰竭相关性研究[摘要]目的 探讨血浆N-末端脑利钠肽（NT-proBNP）与慢性肾脏病（CKD）非透析患者心力衰竭的关系。方法 选择CKD非透析患者132例，按照NYHA心功能分级分为：Ⅰ级组40例，Ⅱ级组34例，Ⅲ级组30例，Ⅳ级组28例。另外选择健康体检者40例作为对照组。分别采用电化学发光法测定血浆NT-proBNP水平，心脏超声测定心脏左室射血分数（LVEF），全自动生化仪检测血肌酐、尿素氮等。 结果 从健康对照组到CKD患者不同心功能组（Ⅰ至Ⅳ），LVEF逐级递减，NT-proBNP水平逐级递增，各组间比较差异均有统计学意义（P均＜0.01）。且CKD患者心功能Ⅰ级组的LVEF显著低于健康对照组，NT-proBNP显著高于健康对照组。不同NYHA心功能分级患者的LVEF随心功能级别增加而显著降低，血浆NT-proBNP浓度随心功能级别增加而显著升高。 结论 CKD非透析患者NT-proBNP水平与心功能、肾功能相关，NT-proBNP水平可作为一项评价CKD非透析患者心功能分级的参考指标之一，值得临床推广。 [关键词]N-末端脑利钠肽；心力衰竭；肾透析；慢性肾脏病 [中图分类号] R692 [文献标识码] B [文章编号]1673-9701（2011） 22-31-03 The Correlation of Plasma N-terminal Pro-brain Natriuretic Peptide and Non-dialysis Patients with Chronic Kidney Disease Complicated with Heart Failure LI Guofu LIU Ting BAO Beiyan Yinzhou Second Hospital of Ningbo City， Zhejiang Province ，Ningbo 315100 ，China [Abstract] Objective To explore the relationship between plasma N-terminal pro-brain natriuretic peptide （NT-proBNP） and chronic kidney disease （CKD） in patients with heart failure without dialysis. Methods There were 132 CKD non-dialysis patients and were divided according to NYHA functional class： Ⅰ level group of 40 patients， Ⅱ grade group of 34 cases， Ⅲ grade group of 30 cases， Ⅳ-level group of 28 cases. Another 40 cases were selected as healthy control group. Determined NT-proBNP levels were by electrochemiluminescence plasma， left ventricular ejection fraction （LVEF） by echocardiographic determination， serum creatinine， urea nitrogen by automatic biochemical analyzer. Results LVEF progressively decreased， NT-proBNP level of incremental， from the healthy control group to the CKD patients with different cardiac function group （Ⅰ to Ⅳ）， the groups were statistically significant differences between （all P ＜0.01）. And LVEF of cardiac function in patients with CKD class Ⅰ group was significantly lower than the control group， NT-proBNP was significantly higher than in the healthy control group. LVEF of different NYHA functional cl