NT―proBNP和RDW在CKD5期急性心衰患者中临床意义.docVIP

NT―proBNP和RDW在CKD5期急性心衰患者中临床意义 　　DOI：10.16662/j.cnki.1674-0742.2017.07.040 　　[摘要] 目的 探?氨基末端B型脑钠肽前体（NT-proBNP）和红细胞分布宽度（RDW）在CKD5期急性心衰患者中的临床意义。方法 便利选取该院2015年1月―2016年8月诊断为急性心衰的CKD5期患者共40例（急性心衰组）及同期无急性心衰的CKD5期患者50例（非急性心衰组）、健康体检者30名（对照组），比较3组NT-proBNP和RDW的差异。结果 急性心衰组NT-proBNP水平为2 190～30 000 pg/mL，中位数30 000 pg/mL，非急性心衰组NT-proBNP水平为264～30 000 pg/mL，中位数8 597 pg/mL，急性心衰组NT-proBNP高于非急性心衰组，差异有统计学意义（P0.05）。急性心衰组RDW为（14.7±1.9）%，非急性心衰组RDW为（13.9±1.2）%，急性心衰组RDW高于非急性心衰组，差异有统计学意义（P0.05）。ROC曲线显示，单项检测中NT-proBNP、RDW的曲线下面积（AUC）分别为0.919和0.624，NT-proBNP的曲线下面积大于RDW，NT-proBNP、RDW联合检测时，曲线下面积增加到0.926。结论 NT-proBNP、RDW对诊断CKD5期患者急性心衰均有一定价值，联合检测NT-proBNP、RDW水平对CKD5期患者急性心衰的诊断价值高于单一指标。 　　[关键词] NT-proBNP；红细胞分布宽度；CKD5期；急性心衰 　　[中图分类号] R692.5；R541.6 [文献标识码] A [文章编号] 1674-0742（2017）03（a）-0040-04 　　Clinical Significance of NT-proBNP and RDW in Patients with Acute Heart Failure During the CKD5 Period 　　WANG Ming-zhe， YANG Feng， ZHONG Xiao-rong， LIN Zhen-ming， ZHONG Xiao-yan 　　Nephrology Department， Fuzhou First Hospital Affiliated to Fujian Medical University， Fuzhou， Fujian Province， 350009 China 　　[Abstract] Objective To discuss the clinical significance of NT-proBNP and RDW in patients with acute heart failure during the CKD5 period. Methods 40 cases of patients with acute heart failure during the CKD5 period in our hospital from January 2015 to August 2016 were convenient selected as the acute heart failure group， while 50 cases of patients without acute heart failure during the CKD5 period at the same period were selected as the non-acute heart failure group， and 30 cases of healthy physical examination people were selected as the control group， and the differences in the NT-proBNP and RDW between the three groups were compared. Results The NT-proBNP level and median in the acute heart failure group were higher than those in the non-acute heart failure group[2 190～30 000 pg/mL， 30 000 pg/mL vs 264～30 000 pg/mL， 8 597 pg/mL]， and the differences had statistical significance（P 　　[Key words] NT