临床肾脏病杂志
臨床腎髒病雜誌
림상신장병잡지
JOURNAL OF CLINICAL NEPHROLOGY
2014年
10期
603-607
,共5页
蔡威巍%徐树人%于颖吉%朱纯%纪培颖
蔡威巍%徐樹人%于穎吉%硃純%紀培穎
채위외%서수인%우영길%주순%기배영
血液透析%同型半胱氨酸%脑钠肽%心血管疾病
血液透析%同型半胱氨痠%腦鈉肽%心血管疾病
혈액투석%동형반광안산%뇌납태%심혈관질병
Hemodialysis%Homocysteine%Brain natriuretic peptide%Cardiovascular disease
目的：探讨维持性血液透析(maintenance hemodialysis,MHD)患者血浆同型半胱氨酸(homocysteine,Hcy)和血清脑钠肽(brain natriuretic peptide,BNP)水平与心血管疾病(cardiovascular disease,CVD)之间的关系。方法将95例 MHD患者分为心血管疾病组(CVD组)55例和无心血管疾病组(NCVD组)40例；另选30名健康对照者(健康对照组),检测各组血浆 Hcy、血清BNP、血肌酐(SCr)、血糖(glucose,GLU)、血白蛋白(albumin,Alb)、血脂并进行比较。结果 MHD患者血浆 Hcy [(26.89±10.12)μmol/L]明显高于健康对照组[(8.05±2.53)μmol/L](P<0.01)；血清 BNP [(1275.02±1123.94)pg/ml]显著高于对照组[(57.82±34.61)pg/ml](P<0.01)；其中 CVD 组血浆 Hcy[(31.73±10.18)μmol/L]高于 NCVD 组[(20.24±5.01)μmol/L](P<0.01)；血清 BNP [(1957.49±1001.83)pg/ml]高于 NCVD组[(336.61±308.22)pg/ml](P<0.01)。以健康对照组血浆 Hcy 均数+2倍标准差(x+2s)(13.11μmol/L)为95%可信度上限,超过此值确定为高同型半胱氨酸血症(Hyperhomocysteinemia,HHcy)。95例 MHD患者 HHcy发生率为87.37%(83/95)；其中CVD组 HHcy占94.55%(52/55),NCVD 组占77.50%(31/40),均明显高于正常对照组6.67%(2/30)(均 P<0.01)。CVD 组和 NCVD 组 SCr、GLU、Alb 及血脂比较,差异无统计学意义(P>0.05)。CVD组血浆 Hcy与 SCr、Alb呈正相关(r=0.380、0.354,P<0.01),NCVD组血浆 HcyA与BNP、SCr、Alb呈正相关(r=0.341、0.337、0.389,P<0.05),血清 BNP 与 Hcy、SCr 呈正相关(r=0.341、0.389,P<0.05)；血浆 Hcy、血清BNP与其余各血生化指标间无相关性(P>0.05)。结论血浆 Hcy、血清BNP水平可作为 MHD患者CVD危险因素的预测指标。
目的：探討維持性血液透析(maintenance hemodialysis,MHD)患者血漿同型半胱氨痠(homocysteine,Hcy)和血清腦鈉肽(brain natriuretic peptide,BNP)水平與心血管疾病(cardiovascular disease,CVD)之間的關繫。方法將95例 MHD患者分為心血管疾病組(CVD組)55例和無心血管疾病組(NCVD組)40例；另選30名健康對照者(健康對照組),檢測各組血漿 Hcy、血清BNP、血肌酐(SCr)、血糖(glucose,GLU)、血白蛋白(albumin,Alb)、血脂併進行比較。結果 MHD患者血漿 Hcy [(26.89±10.12)μmol/L]明顯高于健康對照組[(8.05±2.53)μmol/L](P<0.01)；血清 BNP [(1275.02±1123.94)pg/ml]顯著高于對照組[(57.82±34.61)pg/ml](P<0.01)；其中 CVD 組血漿 Hcy[(31.73±10.18)μmol/L]高于 NCVD 組[(20.24±5.01)μmol/L](P<0.01)；血清 BNP [(1957.49±1001.83)pg/ml]高于 NCVD組[(336.61±308.22)pg/ml](P<0.01)。以健康對照組血漿 Hcy 均數+2倍標準差(x+2s)(13.11μmol/L)為95%可信度上限,超過此值確定為高同型半胱氨痠血癥(Hyperhomocysteinemia,HHcy)。95例 MHD患者 HHcy髮生率為87.37%(83/95)；其中CVD組 HHcy佔94.55%(52/55),NCVD 組佔77.50%(31/40),均明顯高于正常對照組6.67%(2/30)(均 P<0.01)。CVD 組和 NCVD 組 SCr、GLU、Alb 及血脂比較,差異無統計學意義(P>0.05)。CVD組血漿 Hcy與 SCr、Alb呈正相關(r=0.380、0.354,P<0.01),NCVD組血漿 HcyA與BNP、SCr、Alb呈正相關(r=0.341、0.337、0.389,P<0.05),血清 BNP 與 Hcy、SCr 呈正相關(r=0.341、0.389,P<0.05)；血漿 Hcy、血清BNP與其餘各血生化指標間無相關性(P>0.05)。結論血漿 Hcy、血清BNP水平可作為 MHD患者CVD危險因素的預測指標。
목적：탐토유지성혈액투석(maintenance hemodialysis,MHD)환자혈장동형반광안산(homocysteine,Hcy)화혈청뇌납태(brain natriuretic peptide,BNP)수평여심혈관질병(cardiovascular disease,CVD)지간적관계。방법장95례 MHD환자분위심혈관질병조(CVD조)55례화무심혈관질병조(NCVD조)40례；령선30명건강대조자(건강대조조),검측각조혈장 Hcy、혈청BNP、혈기항(SCr)、혈당(glucose,GLU)、혈백단백(albumin,Alb)、혈지병진행비교。결과 MHD환자혈장 Hcy [(26.89±10.12)μmol/L]명현고우건강대조조[(8.05±2.53)μmol/L](P<0.01)；혈청 BNP [(1275.02±1123.94)pg/ml]현저고우대조조[(57.82±34.61)pg/ml](P<0.01)；기중 CVD 조혈장 Hcy[(31.73±10.18)μmol/L]고우 NCVD 조[(20.24±5.01)μmol/L](P<0.01)；혈청 BNP [(1957.49±1001.83)pg/ml]고우 NCVD조[(336.61±308.22)pg/ml](P<0.01)。이건강대조조혈장 Hcy 균수+2배표준차(x+2s)(13.11μmol/L)위95%가신도상한,초과차치학정위고동형반광안산혈증(Hyperhomocysteinemia,HHcy)。95례 MHD환자 HHcy발생솔위87.37%(83/95)；기중CVD조 HHcy점94.55%(52/55),NCVD 조점77.50%(31/40),균명현고우정상대조조6.67%(2/30)(균 P<0.01)。CVD 조화 NCVD 조 SCr、GLU、Alb 급혈지비교,차이무통계학의의(P>0.05)。CVD조혈장 Hcy여 SCr、Alb정정상관(r=0.380、0.354,P<0.01),NCVD조혈장 HcyA여BNP、SCr、Alb정정상관(r=0.341、0.337、0.389,P<0.05),혈청 BNP 여 Hcy、SCr 정정상관(r=0.341、0.389,P<0.05)；혈장 Hcy、혈청BNP여기여각혈생화지표간무상관성(P>0.05)。결론혈장 Hcy、혈청BNP수평가작위 MHD환자CVD위험인소적예측지표。
Objective To study the relationship between plasma homocysteine (Hcy)and ser-um brain natriuretic petide (BNP)and the cardiovascular disease (CVD)in maintenance hemodialysis (MHD)patients.Methods Ninety-five patients with MHD were selected (MHD group)and divided into CVD group (including 55 cases)and NCVD group (including 40 cases)according to the incidence of CVD.Thirty healthy volunteers served as control group.Plasma HCY,serum BNP,serum creatinine (SCr),blood glucose (GLU),serum albumin (Alb)and blood lipid levels were measured and com-pared between MHD group and control group.Results The level of plasma HCY in MHD group was significantly higher than in control group [(26.89±10.12)vs.(8.05±2.53)μmol/L,P<0.01]. The level of serum BNP in MHD group was significantly higher than in control group [(1 275.02 ±1 123.94)vs.(57.82±34.61)pg/ml,P<0.01].In MHD group,the level of plasma HCY in CVD subgroup was significantly higher than in NCVD subgroup [(31.73±10.18)vs.(20.24±5.01)μmol/L,P<0.01].The plasma Hcy in the control group x±2s (13.11μmol/L)was standardized as 95% confidence limit,and that exceeding this value was determined as HHcy.The incidence of HHcy in MHD group was 87.37% (83/95),and that in CVD subgroup and NCVD subgroup was 94.55%(52/55)and 77.50% (31/40)respectively,both were significantly higher than in control group [6.67% (2/30),P<0.01].There was no significant difference in SCr,GLU,Alb and blood lipid be-tween CVD subgroup and NCVD subgroup (P>0.05).In MHD group,the level of plasma Hcy in CVD subgroup was positively correlated with SCr and Alb (r=0.380 and 0.354,P<0.01).The level of plasma Hcy in NCVD subgroup was positively correlated with SCr,Alb and BNP (r=0.341,0.337 and 0.389,P<0.05).The level of BNP was positively correlated with plasma Hcy and SCr (r=0.341 and 0.389,P<0.05).There was no correlation between plasma Hcy,BNP and the rest of blood serum biochemical markers (P>0.05).Conclusions Plasma Hcy and serum BNP levels can be used as a predictor of CVD complications in MHD patients.
