中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
34期
23-25
,共3页
利钠肽,脑%血液滤过%心胸比
利鈉肽,腦%血液濾過%心胸比
리납태,뇌%혈액려과%심흉비
Natriuretic peptide,brain%Hemofiltration%Cardiothoracic ration
目的 探讨血浆N末端脑利钠肽(NT-BNP)对维持性血液透析(MHD)患者透析充分性的评估价值.方法 选取行MHD的患者112例,根据心胸比值分为血液透析充分组(A组,63例,心胸比值＜0.5)及血液透析不充分组(B组,49例,心胸比值≥0.5),比较两组透析前、透析结束时、透析后4h、透析后24h血浆NT-BNP水平的变化,检查透析前后校正后下腔静脉宽度(VCD),并对透析后的血浆NT-BNP水平与心胸比值、校正后VCD进行相关性分析.结果 A、B组透析前NT-BNP分别为(13 808±7611)、(25 573±8444) ng/L,差异有统计学意义(P＜0.01),透析结束时两组NT-BNP均升高,但差异无统计学意义(P＞0.05),透析后4h两组NT-BNP均显著下降(P＜0.01),透析后4h两组NT-BNP分别为(8256±6611)、(21 320±6828) ng/L,B组NT-BNP显著高于A组(P＜0.01).透析后24 h,A组NT-BNP仍处于较低水平,但B组NT-BNP再次呈上升趋势.透析前,两组校正后VCD比较差异无统计学意义(P＞0.05),透析后,两组校正后VCD均较透析前下降,但A组透析前后比较差异无统计学意义(P＞0.05),B组透析前后比较差异有统计学意义(P＜0.05).血浆NT-BNP水平与心胸比值、校正后VCD均呈显著正相关(r=0.462,P＜ 0.01；r =0.513,P＜0.01).结论 血浆NT-BNP可在一定程度上反映MHD患者的容量负荷及尿素清除指数,可更为全面地评价透析的充分性.
目的 探討血漿N末耑腦利鈉肽(NT-BNP)對維持性血液透析(MHD)患者透析充分性的評估價值.方法 選取行MHD的患者112例,根據心胸比值分為血液透析充分組(A組,63例,心胸比值＜0.5)及血液透析不充分組(B組,49例,心胸比值≥0.5),比較兩組透析前、透析結束時、透析後4h、透析後24h血漿NT-BNP水平的變化,檢查透析前後校正後下腔靜脈寬度(VCD),併對透析後的血漿NT-BNP水平與心胸比值、校正後VCD進行相關性分析.結果 A、B組透析前NT-BNP分彆為(13 808±7611)、(25 573±8444) ng/L,差異有統計學意義(P＜0.01),透析結束時兩組NT-BNP均升高,但差異無統計學意義(P＞0.05),透析後4h兩組NT-BNP均顯著下降(P＜0.01),透析後4h兩組NT-BNP分彆為(8256±6611)、(21 320±6828) ng/L,B組NT-BNP顯著高于A組(P＜0.01).透析後24 h,A組NT-BNP仍處于較低水平,但B組NT-BNP再次呈上升趨勢.透析前,兩組校正後VCD比較差異無統計學意義(P＞0.05),透析後,兩組校正後VCD均較透析前下降,但A組透析前後比較差異無統計學意義(P＞0.05),B組透析前後比較差異有統計學意義(P＜0.05).血漿NT-BNP水平與心胸比值、校正後VCD均呈顯著正相關(r=0.462,P＜ 0.01；r =0.513,P＜0.01).結論 血漿NT-BNP可在一定程度上反映MHD患者的容量負荷及尿素清除指數,可更為全麵地評價透析的充分性.
목적 탐토혈장N말단뇌리납태(NT-BNP)대유지성혈액투석(MHD)환자투석충분성적평고개치.방법 선취행MHD적환자112례,근거심흉비치분위혈액투석충분조(A조,63례,심흉비치＜0.5)급혈액투석불충분조(B조,49례,심흉비치≥0.5),비교량조투석전、투석결속시、투석후4h、투석후24h혈장NT-BNP수평적변화,검사투석전후교정후하강정맥관도(VCD),병대투석후적혈장NT-BNP수평여심흉비치、교정후VCD진행상관성분석.결과 A、B조투석전NT-BNP분별위(13 808±7611)、(25 573±8444) ng/L,차이유통계학의의(P＜0.01),투석결속시량조NT-BNP균승고,단차이무통계학의의(P＞0.05),투석후4h량조NT-BNP균현저하강(P＜0.01),투석후4h량조NT-BNP분별위(8256±6611)、(21 320±6828) ng/L,B조NT-BNP현저고우A조(P＜0.01).투석후24 h,A조NT-BNP잉처우교저수평,단B조NT-BNP재차정상승추세.투석전,량조교정후VCD비교차이무통계학의의(P＞0.05),투석후,량조교정후VCD균교투석전하강,단A조투석전후비교차이무통계학의의(P＞0.05),B조투석전후비교차이유통계학의의(P＜0.05).혈장NT-BNP수평여심흉비치、교정후VCD균정현저정상관(r=0.462,P＜ 0.01；r =0.513,P＜0.01).결론 혈장NT-BNP가재일정정도상반영MHD환자적용량부하급뇨소청제지수,가경위전면지평개투석적충분성.
Objective To investigate the value of plasma N terminal brain natriuretic peptide (NT-BNP) in dialysis adequacy assessment of maintenance hemodialysis (MHD).Methods One hundred and twelve MHD patients were divided into hemodialysis adequacy group (group A,63 patients,cardiothoracic ration ＜0.5) and hemodialysis inadequate group (group B,49 patients,cardiothoracic ration ≥ 0.5).The plasma NT-BNP levels of pre-dialysis,dialysis end,4th and 24th hour after dialysis were compared.Before and after dialysis the inferior vena cava diameter (VCD) was checked.The correlation between NT-BNP level at the end of dialysis,cardiothoracic ration and post dialysis VCD were analyzed.Results The levels of NT-BNP in group A,B before dialysis were(13 808 ± 7611) and (25 573 ± 8444)ng/L respectively,and there was significant difference (P ＜ 0.01).The levels of NT-BNP in two groups increased at the end of dialysis,but there was no significant difference (P ＞0.05).Then the levels of NT-BNP in two groups decreased significantly at 4th hour after dialysis (P ＜ 0.01).The levels of NT-BNP in two groups at 4th hour after dialysis were (8256 ±6611) and (21 320 ±6828) ng/L,and there was significant difference (P＜ 0.01).At 24th hour after dialysis,the level of NT-BNP in group A was still at a low level,but in group B,the level of NT-BNP increased again.Before dialysis,the levels of VCD between two groups had no significant difference (P ＞ 0.05).After dialysis,the level of VCD in group B decreased significantly(P ＜ 0.05).After dialysis,the level of VCD in group B was significantly higher than that in group A(P＜ 0.05).The level of NT-BNP had positive relationship with cardiothoracic ration and VCD (r =0.462,P＜ 0.01 ;r =0.513,P＜ 0.01).Conclusion The level of NT-BNP can reflect the volume overload and urea clearance index of MHD,which may be a more comprehensive evaluation index of the adequacy of dialysis.
