中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
1期
39-41
,共3页
高血压%肾小球滤过率%利尿钠激素%心室功能,左
高血壓%腎小毬濾過率%利尿鈉激素%心室功能,左
고혈압%신소구려과솔%이뇨납격소%심실공능,좌
Hypertension%Glomerular filtration rate%Natriuretic hormone%Ventricular function,left
目的 通过观察原发性高血压患者在不同心功能状态下GFR下降对血浆氨基末端-脑钠肽前体(NT-proBNP)的影响,了解应用NT-proBNP判断原发性高血压患者心功能的准确性.方法 回顾性分析89例原发性高血压患者,按UCG检查结果分成心功能正常组(43例)和异常组(46例).患者均接受GFR、血浆NT-proBNP和其他心、肾相关指标测定.分析心功能正常时影响血浆NT-proBNP的因素及不同心功能情况下GFR正常(＞80 ml/min)和GFR降低(≤80 ml/min)对血浆NT-proBNP影响的差异.用两样本t检验、秩和检验和多元回归分析进行统计学处理.结果 心功能正常时GFR(β=-0.361,P＜0.05)和左室舒张末期直径(LVEDD)(β=0.385,P＜0.05)较LVEF(β=0.189,P＞0.05)和室间隔厚度(β=0.003,P＞0.05)等其他指标对血浆NT-proBNP影响更具意义.心功能正常和异常组的血浆NT-proBNP质量浓度中位数分别为13.18及24.14 μg/L,差异有统计学意义(Z=-3.19,P＜0.01)；GFR降低时,心功能正常和异常患者(分别为6例和19例)血浆NT-proBNP质量浓度中位数分别为38.45和44.20 μg/L,差异无统计学意义(Z=-0.45,P＞0.05).GFR正常的患者心功能正常和异常分别为37和27例,血浆NT-proBNP质量浓度中位数分别为12.51及20.31 μg/L,均低于GFR降低时相应水平(Z=-2.76,均P＜0.05).心功能正常而GFR下降患者,其血浆NT-proBNP与心功能异常而GFR正常患者差异无统计学意义(38.45与20.31 μg/L,Z=-2.18,P＞0.05).结论 在原发性高血压患者应用NT-proBNP判断心功能异常的严重性时需注意GFR降低的影响.
目的 通過觀察原髮性高血壓患者在不同心功能狀態下GFR下降對血漿氨基末耑-腦鈉肽前體(NT-proBNP)的影響,瞭解應用NT-proBNP判斷原髮性高血壓患者心功能的準確性.方法 迴顧性分析89例原髮性高血壓患者,按UCG檢查結果分成心功能正常組(43例)和異常組(46例).患者均接受GFR、血漿NT-proBNP和其他心、腎相關指標測定.分析心功能正常時影響血漿NT-proBNP的因素及不同心功能情況下GFR正常(＞80 ml/min)和GFR降低(≤80 ml/min)對血漿NT-proBNP影響的差異.用兩樣本t檢驗、秩和檢驗和多元迴歸分析進行統計學處理.結果 心功能正常時GFR(β=-0.361,P＜0.05)和左室舒張末期直徑(LVEDD)(β=0.385,P＜0.05)較LVEF(β=0.189,P＞0.05)和室間隔厚度(β=0.003,P＞0.05)等其他指標對血漿NT-proBNP影響更具意義.心功能正常和異常組的血漿NT-proBNP質量濃度中位數分彆為13.18及24.14 μg/L,差異有統計學意義(Z=-3.19,P＜0.01)；GFR降低時,心功能正常和異常患者(分彆為6例和19例)血漿NT-proBNP質量濃度中位數分彆為38.45和44.20 μg/L,差異無統計學意義(Z=-0.45,P＞0.05).GFR正常的患者心功能正常和異常分彆為37和27例,血漿NT-proBNP質量濃度中位數分彆為12.51及20.31 μg/L,均低于GFR降低時相應水平(Z=-2.76,均P＜0.05).心功能正常而GFR下降患者,其血漿NT-proBNP與心功能異常而GFR正常患者差異無統計學意義(38.45與20.31 μg/L,Z=-2.18,P＞0.05).結論 在原髮性高血壓患者應用NT-proBNP判斷心功能異常的嚴重性時需註意GFR降低的影響.
목적 통과관찰원발성고혈압환자재불동심공능상태하GFR하강대혈장안기말단-뇌납태전체(NT-proBNP)적영향,료해응용NT-proBNP판단원발성고혈압환자심공능적준학성.방법 회고성분석89례원발성고혈압환자,안UCG검사결과분성심공능정상조(43례)화이상조(46례).환자균접수GFR、혈장NT-proBNP화기타심、신상관지표측정.분석심공능정상시영향혈장NT-proBNP적인소급불동심공능정황하GFR정상(＞80 ml/min)화GFR강저(≤80 ml/min)대혈장NT-proBNP영향적차이.용량양본t검험、질화검험화다원회귀분석진행통계학처리.결과 심공능정상시GFR(β=-0.361,P＜0.05)화좌실서장말기직경(LVEDD)(β=0.385,P＜0.05)교LVEF(β=0.189,P＞0.05)화실간격후도(β=0.003,P＞0.05)등기타지표대혈장NT-proBNP영향경구의의.심공능정상화이상조적혈장NT-proBNP질량농도중위수분별위13.18급24.14 μg/L,차이유통계학의의(Z=-3.19,P＜0.01)；GFR강저시,심공능정상화이상환자(분별위6례화19례)혈장NT-proBNP질량농도중위수분별위38.45화44.20 μg/L,차이무통계학의의(Z=-0.45,P＞0.05).GFR정상적환자심공능정상화이상분별위37화27례,혈장NT-proBNP질량농도중위수분별위12.51급20.31 μg/L,균저우GFR강저시상응수평(Z=-2.76,균P＜0.05).심공능정상이GFR하강환자,기혈장NT-proBNP여심공능이상이GFR정상환자차이무통계학의의(38.45여20.31 μg/L,Z=-2.18,P＞0.05).결론 재원발성고혈압환자응용NT-proBNP판단심공능이상적엄중성시수주의GFR강저적영향.
Objective To assess the diagnostic accuracy of NT-proBNP in hypertension patients by observing the effect of decreased GFR on N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration in patients with different cardiac function.Methods Eighty-nine hypertension patients were divided into two groups based on the results of UCG.Forty-three patients had normal left ventricular function and 46 patients had dysfunction.GFR,NT-proBNP and other biochemical markers of cardiac and renal function were measured.The factors affecting the NT-proBNP concentration under normal left ventricular function were analyzed,and the diagnostic value of NT-proBNP affected by normal or decreased GFR(＞ 80 ml/min or ≤80 ml/min) under different left ventricular functions were further assessed.The two-sample t test,rank sum test and multiple regression analysis were used to analyze their statistical difference and relationship.Results In patients with normal left ventricular function,GFR (β =-0.361,P ＜ 0.05) and left ventricular end-diastolic diameter (LVEDD,β =0.385,P ＜ 0.05) were significant factors to NT-proBNP level.They were both meaningful compared with LVEF (β =0.189,P ＞0.05) and septal thickness (β =0.003,P ＞ 0.05).The median concentration of NT-proBNP was 13.18 and 24.14 μg/L in patients with normal left ventricular function and dysfunction,respectively (Z =-3.19,P ＜ 0.01).While in patients with decreased GFR,6 cases with normal left ventricular function and 19 cases with dysfunction had a median concentration of NT-proBNP of 38.45 and 44.20 μg/L,respectively (Z =-0.45,P ＞ 0.05).In patients with normal GFR,37 cases with normal left ventricular function and 27 cases with dysfunction had a median concentration of NT-proBNP of 12.51 and 20.31 μg/L,which was lower than that of patients with decreased GFR (Z =-2.76,both P ＜ 0.05).The NT-proBNP concentration had no significant difference between patients of normal left ventricular function with decreased GFR and patients of dysfunction with normal GFR (38.45 and20.31 μg/L,Z=-2.18,P＞0.05).Conclusion In hypertension patients,the effect of decreased GFR on assessing the diagnostic accuracy of NT-proBNP for left ventricular dysfunction should be considered.
