【摘要】 目的探讨血N末端B型钠尿肽前体(NT-proBNP)在维持性血液透析隐性水肿患者中的应用效果。方法检测32例临床无明显水肿、心力衰竭表现的维持性血液透析终末期肾脏病患者血NT-proBNP水平,同时监测患者体重(BW)、动态血压监测24 h平均收缩压/24 h平均舒张压(24 h MSBP/24 h MDBP)、血红蛋白(HGB)、白蛋白(ALB)、评估肾小球滤过率(eGFR)、24 h尿量(24 h UV)及心脏超声指标[室间隔厚度(IVST)、左室后壁舒张末厚度(LVPWT)、左室舒张末内径(LVEDd)],并计算左室质量指数(LVMI),比较和分析治疗前后上述指标的检测结果。结果治疗前后的HGB、ALB、24 h UV、eGFR、LVMI比较差异无统计学意义(P>0.05);治疗后的24 h MSBP、24 h MDBP、BW及NT-proBNP水平低于治疗前,差异有统计学意义(P<0.05)。NT-proBNP降幅与BW下降值呈正相关(r=0.397,P=0.025),与24 h MSBP、24 h MDBP及LVMI下降值无相关性(P>0.05)。结论要重视对血液透析隐性水肿患者干体重的定期评估,血NT-proBNP水平动态检测有助于判断患者的BW变化。更多还原

【Abstract】 Objective To evaluate the application effect of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in maintenance hemodialysis(MHD)patients with recessive edema. Methods The level of blood NT-proBNP was tested pre-and post-dialysis until obtaining dry weight in 32 cases of MHD patients with recessive edema and without clinical manifestation of heart failure.Clinical data including body weight(BW),24-hour mean systolic/diastolic blood pressure(24 h MSBP/24 h MDBP),hemoglobin(HGB),albumin(ALB),estimated glomerular filtration rate(eGFR),24 hours urine volume(24 h UV)was collected and analyzed respectively as well,ultrasonic cardiography(UCG) examination including interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDd)and left ventricular mass index(LVMI)was determined respectively.The detection result of index before and after treatment was compared and analysed. Results HGB,ALB,24 h UV,eGFR,LVMI before and after treatment was compared respectively,with no statistical difference(P>0.05).24 h MSBP,24 h MDBP,BW and NT-proBNP after treatment was lower than that before treatment respectively,with statistical difference(P<0.05).The decreasing range of blood NT-proBNP was positively correlated with BW-loss(r=0.397,P=0.025),but no significant correlation with 24 h MSBP,24 h MDBP and LVMI(P>0.05). Conclusion Dry weight should be periodically evaluated in MHD patients with recessive edema,the decreasing range of blood NT-proBNP is helpful to estimate the change of patient′s BW更多还原