中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2010年
8期
1026-1028,后插2
,共4页
赵爱国%郭小云%夏天%苏如松
趙愛國%郭小雲%夏天%囌如鬆
조애국%곽소운%하천%소여송
利钠肽,脑%心力衰竭,充血性%肾功能衰竭
利鈉肽,腦%心力衰竭,充血性%腎功能衰竭
리납태,뇌%심력쇠갈,충혈성%신공능쇠갈
Natriuretic peptide,Brain%Heart failure,Congestive%Kidney failure
目的 观察肾小球滤过率(eGFR)与脑钠肽(BNP)之间的关系,比较慢性肾衰竭合并心力衰竭(心衰)患者不同eGFR水平BNP的诊断界值(cut-off值),研究肾功能对BNP应用于心衰诊断的影响.方法 对老年eCRF合并心衰未透析患者52例及无心衰29例和老年健康体检者30例(健康对照组)采用酶联免疫吸附法测定血清BNP浓度,根据eGFR分组进行对比.结果 eGFR小于30 ml、30～60 ml心衰组BNP水平均高于eGFR小于30 ml、30～60 ml无心衰对照组和eGFR大于60 ml健康对照组(P＜0.05),eGFR小于30 ml、30～60ml无心衰对照组BNP水平较eGFR大于60 ml健康对照组显著升高(P＜0.05).eGFR小于30 ml心衰组与eGFR 30～60 ml心衰组BNP相比较,差异无统计学意义(t=0.62,P＞0.05).eGFR与BNP心衰组无相关,无心衰对照组呈负相关(心衰组γ=-0.081,P＞0.05,对照组γ=-0.581,P＜0.01).eGFR30～60 ml心衰组ROC曲线下面积(AUC)为0.951,1 500 ng/L作为临界值的敏感度为96.4%,特异度为86.7%;eGFR小于30 ml心衰组AUC为0.860,1 850 ng/L作为临界值的敏感度为66.7%,特异度为92.9%.结论 CRF合并心衰时心衰是导致BNP升高的主要原因,BNP可作为判断CRF患者是否合并心衰的诊断指标.
目的 觀察腎小毬濾過率(eGFR)與腦鈉肽(BNP)之間的關繫,比較慢性腎衰竭閤併心力衰竭(心衰)患者不同eGFR水平BNP的診斷界值(cut-off值),研究腎功能對BNP應用于心衰診斷的影響.方法 對老年eCRF閤併心衰未透析患者52例及無心衰29例和老年健康體檢者30例(健康對照組)採用酶聯免疫吸附法測定血清BNP濃度,根據eGFR分組進行對比.結果 eGFR小于30 ml、30～60 ml心衰組BNP水平均高于eGFR小于30 ml、30～60 ml無心衰對照組和eGFR大于60 ml健康對照組(P＜0.05),eGFR小于30 ml、30～60ml無心衰對照組BNP水平較eGFR大于60 ml健康對照組顯著升高(P＜0.05).eGFR小于30 ml心衰組與eGFR 30～60 ml心衰組BNP相比較,差異無統計學意義(t=0.62,P＞0.05).eGFR與BNP心衰組無相關,無心衰對照組呈負相關(心衰組γ=-0.081,P＞0.05,對照組γ=-0.581,P＜0.01).eGFR30～60 ml心衰組ROC麯線下麵積(AUC)為0.951,1 500 ng/L作為臨界值的敏感度為96.4%,特異度為86.7%;eGFR小于30 ml心衰組AUC為0.860,1 850 ng/L作為臨界值的敏感度為66.7%,特異度為92.9%.結論 CRF閤併心衰時心衰是導緻BNP升高的主要原因,BNP可作為判斷CRF患者是否閤併心衰的診斷指標.
목적 관찰신소구려과솔(eGFR)여뇌납태(BNP)지간적관계,비교만성신쇠갈합병심력쇠갈(심쇠)환자불동eGFR수평BNP적진단계치(cut-off치),연구신공능대BNP응용우심쇠진단적영향.방법 대노년eCRF합병심쇠미투석환자52례급무심쇠29례화노년건강체검자30례(건강대조조)채용매련면역흡부법측정혈청BNP농도,근거eGFR분조진행대비.결과 eGFR소우30 ml、30～60 ml심쇠조BNP수평균고우eGFR소우30 ml、30～60 ml무심쇠대조조화eGFR대우60 ml건강대조조(P＜0.05),eGFR소우30 ml、30～60ml무심쇠대조조BNP수평교eGFR대우60 ml건강대조조현저승고(P＜0.05).eGFR소우30 ml심쇠조여eGFR 30～60 ml심쇠조BNP상비교,차이무통계학의의(t=0.62,P＞0.05).eGFR여BNP심쇠조무상관,무심쇠대조조정부상관(심쇠조γ=-0.081,P＞0.05,대조조γ=-0.581,P＜0.01).eGFR30～60 ml심쇠조ROC곡선하면적(AUC)위0.951,1 500 ng/L작위림계치적민감도위96.4%,특이도위86.7%;eGFR소우30 ml심쇠조AUC위0.860,1 850 ng/L작위림계치적민감도위66.7%,특이도위92.9%.결론 CRF합병심쇠시심쇠시도치BNP승고적주요원인,BNP가작위판단CRF환자시부합병심쇠적진단지표.
Objective To investigate the influence of renal function on serum BNP in the diagnosis of CRF with heart failure by observing the relationship between eGFR and BNP in serum and comparing cut-off values of BNP in different eGFR levels. Methods The elderly participants were enrolled in the study, including 52 patients with heart failure, and 29 patients without heart failure and 30 healthy controls. Serum BNP level was measured by ELISA.Results The level of serum BNP increased significantly in subjects with heart failure compared with those with renal dysfunction for no-heart failure patients (P ＜ 0.05) and healthy controls. BNP level was significantly higher in CRF no-heart failure patients than in control subjects. eGFR showed negative correlation with BNP in ESRD no-heart failure patients (γ= -0. 581, P ＜ 0.01). There was no correlation between eGFR and ESRD with heart failure patients (γ= - 0.081, P ＞ 0.05). The AUC of BNP in patients (eGFR 30 ～ 60 ml) was 0. 951, when cut-off value was 1 500 ng/L,the sensitivity and specificity of BNP were 96.4% and 86. 7% respectively. The AUC of BNP in patients(eGFR ＜30 ml)was 0. 860, when cut-off value was 1 850 ng/L,the sensitivity and specificity of B NP were 66.7% and 92.9%respectively. Conclusions Heart failure was major factor result in higher levels of BNP in chronic renal failure with heart failure patients. BNP could be used as a diagnostic marker for CRF with heart failure patients.
