B型钠尿肽前体和肌钙蛋白T在预测高血压肾损害进展中价值.doc

B型钠尿肽前体和肌钙蛋白T在预测高血压肾损害进展中价值 　　【摘要】目的评价B型钠尿肽前体(pro-BNP)和肌钙蛋白T(TnT)在预测高血压肾损害中的意义。方法121例高血压病患者, 随机分为两组, 即TnT 和pro-BNP 正常的对照组( 60 例) 和TnT 和pro-BNP 升高的观察组( 61例), 3、5 年后检测两组的尿蛋白、血肌酐、TnT 和pro-BNP, 然后进行比较。结果 3年后观察组61例高血压病患者中发生肾功能损害12例(19.67%) , 5 年后发生肾功能损害21例(34.43%)；3 年后对照组60例高血压病患者中发生肾功能损害4例(6.67%), 5年后发生肾功能损害6例(10.00%), 两组比较差异有统计学意义(P0.05)；观察组pro-BNP、TnT、血肌酐、尿微量蛋白水平与对照组比较, 差异有统计学意义(P0.05)。结论 pro-BNP和TnT可预测高血压肾损害进展, 具有重要的临床价值。 　　 　　【关键词】B型钠尿肽前体；肌钙蛋白T；高血压肾损害 　　 　　Predictive value of B-type natriuretic peptide precursor and cardiac troponin T in hypertensive renal damage progression PENG Wei-ping, WU Chun-song, YE Xiao-lian, et al. Department of Internal Medicine, Lianzhou Peoples Hospital, Lianzhou 513 400, China 　　【Abstract】Objective To evaluate the B-type natriuretic peptide precursor (Pro-BNP) and troponin T (TnT) significance in predicting hypertensive renal damage. Methods Dividing 121 patients with hypertension randomly into two groups, namely TnT and pro-BNP normal control group(60 cases) and pro-BNP and TnT elevated observation group(61 cases), 3 years, 5 years after the urine protein were detected, serum creatinine, TnT and pro-BNP, and then for comparison. Results Three years later, observation group had 12(19.67%) cases of hypertension in renal dysfunction, 4 cases(6.67%) in control group, 21 cases(34.43%) occurs renal dysfunction after five years, 6 cases (10.00%) in control group, the difference was statistically significant(P0.05), pro-BNP, TnT, serum creatinine and urine protein levels compared with control group, the difference was statistically significant(P0.05). Conclusion pro-BNP and TnT predictable progress hypertensive renal damage has important clinical value. 　　【Key words】B-type natriuretic peptide precursor; Troponin T; Hypertensive renal damage由于降压药物的广泛应用, 高血压引起的心脑血管疾病有所下降, 但高血压肾损害引起的终末期肾脏疾病( ESRD) 比例却明显增加, 我国全国性透析登记CNRDS 数据显示,2011 年新导入的透析患者中, 由高血压肾损害引起的ESRD 患者占9.9%, 居原发性肾小球疾病和糖尿病肾病之后, 位列第3位。欧洲肾脏学会-欧洲透析和移植学会( ERA-EDTA) 数据显示, ESRD 患者中17% 的原