中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2015年
7期
587-589
,共3页
脑钠肽%维持性血透%超滤量
腦鈉肽%維持性血透%超濾量
뇌납태%유지성혈투%초려량
Brain natriuretic peptide%Maintain hemodialysis%Ultrafiltration
目的：：分析维持性血透( maintain hemodialysis,MHD)患者血透前后血清脑钠肽( brain natriuretic peptide,BNP)水平的变化及其意义。方法：以30例非CKD患者为健康对照组,并选择我院60例病情稳定且近期无急性心血管事件的MHD患者,分别检测同一次血透前后血清BNP水平,同时应用心脏超声心动图检测患者左心房内径( LAD)、左心室舒张末内径( LVDd)、左心室收缩末内径( LVDs)、室间隔厚度( IVST)、左心室后壁厚度( LVPWT)、左心室射血分数( LVEF)等,计算左心室心肌重量(LVM),探讨BNP与MHD患者左心室结构、功能和血容量的关系。结果：(1)MHD患者血透前、后血清BNP水平均显著高于对照组(P<0.01),且透析后BNP水平较血透前显著下降(P<0.01)；(2)MHD患者LAD、LVDd、(LVDs、IVST、LVPWT、LVEF、LVM水平均显著高于对照组(P<0.01)；(3)MHD患者血清BNP水平与LVDd、LVDs、LVPWT、LVM呈显著正相关,与LVEF呈显著负相关,与LAD、IVST无显著相关性；(4) MHD患者单次透析超滤量与血透前后BNP差值呈显著正相关(P<0.05)。结论：MHD患者BNP水平普遍升高,并且与左心室功能及血容量负荷密切相关,对评估MHD患者心功能状况、指导超滤量的设置有一定的临床指导价值。
目的：：分析維持性血透( maintain hemodialysis,MHD)患者血透前後血清腦鈉肽( brain natriuretic peptide,BNP)水平的變化及其意義。方法：以30例非CKD患者為健康對照組,併選擇我院60例病情穩定且近期無急性心血管事件的MHD患者,分彆檢測同一次血透前後血清BNP水平,同時應用心髒超聲心動圖檢測患者左心房內徑( LAD)、左心室舒張末內徑( LVDd)、左心室收縮末內徑( LVDs)、室間隔厚度( IVST)、左心室後壁厚度( LVPWT)、左心室射血分數( LVEF)等,計算左心室心肌重量(LVM),探討BNP與MHD患者左心室結構、功能和血容量的關繫。結果：(1)MHD患者血透前、後血清BNP水平均顯著高于對照組(P<0.01),且透析後BNP水平較血透前顯著下降(P<0.01)；(2)MHD患者LAD、LVDd、(LVDs、IVST、LVPWT、LVEF、LVM水平均顯著高于對照組(P<0.01)；(3)MHD患者血清BNP水平與LVDd、LVDs、LVPWT、LVM呈顯著正相關,與LVEF呈顯著負相關,與LAD、IVST無顯著相關性；(4) MHD患者單次透析超濾量與血透前後BNP差值呈顯著正相關(P<0.05)。結論：MHD患者BNP水平普遍升高,併且與左心室功能及血容量負荷密切相關,對評估MHD患者心功能狀況、指導超濾量的設置有一定的臨床指導價值。
목적：：분석유지성혈투( maintain hemodialysis,MHD)환자혈투전후혈청뇌납태( brain natriuretic peptide,BNP)수평적변화급기의의。방법：이30례비CKD환자위건강대조조,병선택아원60례병정은정차근기무급성심혈관사건적MHD환자,분별검측동일차혈투전후혈청BNP수평,동시응용심장초성심동도검측환자좌심방내경( LAD)、좌심실서장말내경( LVDd)、좌심실수축말내경( LVDs)、실간격후도( IVST)、좌심실후벽후도( LVPWT)、좌심실사혈분수( LVEF)등,계산좌심실심기중량(LVM),탐토BNP여MHD환자좌심실결구、공능화혈용량적관계。결과：(1)MHD환자혈투전、후혈청BNP수평균현저고우대조조(P<0.01),차투석후BNP수평교혈투전현저하강(P<0.01)；(2)MHD환자LAD、LVDd、(LVDs、IVST、LVPWT、LVEF、LVM수평균현저고우대조조(P<0.01)；(3)MHD환자혈청BNP수평여LVDd、LVDs、LVPWT、LVM정현저정상관,여LVEF정현저부상관,여LAD、IVST무현저상관성；(4) MHD환자단차투석초려량여혈투전후BNP차치정현저정상관(P<0.05)。결론：MHD환자BNP수평보편승고,병차여좌심실공능급혈용량부하밀절상관,대평고MHD환자심공능상황、지도초려량적설치유일정적림상지도개치。
Objective:To explore the abnormal levels of brain natriuretic peptide ( BNP) in maintain hemodialysis( MHD) patients and its significance by investigating the BNP levels before and after dialysis, and comparing them with the results of ultrasonic cardiography. Methods:We recruited 60 MHD patients that were in a stable clinic status without signs of cardiovascular disease. Blood samples were collected at the start and end of a dialysis session in order to detect the serum BNP level. Left ventricular diameter ( LVD) , left atrial diameter ( LAD) , left ventricular posterior wall thickness( LVPWT) , interventricular septal thickness( IVST) and left ventricular ejection fraction ( LVEF) were evaluated by ultrasonic cardiography. The relationship between serum BNP level and left heart failure in these patients was analyzed. Results:In MHD patients, the pre- and post-dialysis serum BNP levels were sig-nificantly higher than those of control group (P<0. 01), and the values declined after each dialysis session. The levels of LAD, LVDd, (LVDs, IVST, LVPWT, LVEF and LVM in MHD patients were significantly higher than that in control group (P<0. 01). Serum BNP level has positive correlations with the levels of LVDd, LVDs, LVPWT and LVM, but has a negative correlation with the level of LVEF(P<0. 05), and has no correlations with the levels of LAD, IVST. Ultrafiltration notable correlated with variation of BNP level (r=0. 221 5, P<0. 05). Conclusion:Higher serum BNP was frequently seen in MHD patient, and was closely related with the poor cardiac function and volume overload. And it may have an important clinical value to evaluate the heart function of MHD patient. The detection of plasma BNP may estimate the ultrafiltration of MHD patients.
