摘要
目的 探讨N末端B型脑钠肽前体（NT-proBNP）与血清肌酐（SCr）比值、血清胱抑素C（SCys-C）比值对慢性肾脏病（CKD）并心力衰竭（简称心衰）的临床诊断价值.方法 随机选取广东省第二人民医院CKD（部分伴心衰）志愿患者,分出CKD 1～5期,各期标明心衰组与无心衰组,对照组为非CKD者;各组同时采外周静脉血测血尿素氮（BUN）、SCr、SCys-C、NT-proBNP及NT-proBNP/SCr、NT-proBNP/SCys-C;NT-proBNP、NT-proBNP/SCr、NT-proBNP/SCys-C分别与无心衰组CKD 1～5期、BUN、SCr、SCys-C、GFR作相关分析,各组间NT-proBNP、NT-proBNP/SCr值、NT-proBNP/SCys-C值间分别进行多重交叉对比研究.结果 NT-proBNP分别与无心衰组CKD 1～5期、BUN、SCr、SCys-C、GFR显著相关（P＜0.01）,而NT-proBNP/SCr值、NT-proBNP/SCys-C值则无;CKD各期及对照组中的各心衰组NT-proBNP、NT-proBNP/SCr值、NT-proBNP/SCys-C值均显著大于无心衰组（P＜0.01）;CKD 1～5期心衰组及无心衰组间NT-proBNP随CKD分期进展而显著升高（P＜0.05）,而心衰组中NT-proBNP/SCr值、NT-proBNP/SCys-C值均随CKD分期进展而显著下降（P＜0.05）,但CKD各期NT-proBNP/SCr值始终＞ 10.58、NT-proBNP/SCys-C值始终＞1012.22;无心衰组间CKD各期该值无此规律.结论 NT-proBNP/SCr值、NT-proBNP/SCys-C值可消除肾功能影响而成为独立评判CKD伴心衰的临床指标.
Objective To discuss the diagnostic value of the ratios of N-terminal B-type brain natriuretic peptide precursor （NT-proBNP） and serum creatinine （SCr）,serum cystatin C （SCys-C） in chronic kidney disease （CKD） combined with heart failure.Methods CKD patients （part with heart failure） in our hospital were randomly selected and distinguished CKD1-5 period,each period divided into heart failure group and without heart failure group,people without CKD as control group.Collected peripheral venous blood of all groups at the same time to measure blood urea nitrogen （BUN）,SCr,SCys-C,NT-proBNP and NT-proBNP/SCr,NT-proBNP/SCys-C.Did correlation analysis between NT-proBNP,NT-proBNP/SCr,NT-proBNP/SCys-C and phase CKD1-5,BUN,SCr,SCys-C and GFR in without heart failure group,and did multiple cross comparison research among NT-proBNP,NT-proBNP/SCr,NT-proBNP/SCys-C in each group.Results NT-proBNP was significantly correlated with phase CKD1-5,BUN,SCr,SCys-C,GFR in without heart failure group （P〈0.01）,while NT-proBNP/SCr,NT-proBNP/SCys-C were not.In phase CKD1-5 and control group,NT-proBNP,NT-proBNP/SCr,NT-proBNP/SCys-C in heart failure group were all significantly higher than those in without heart failure group （P〈0.01）.NT-proBNP significantly increased as the progress of CKD stage in heart failure group and without heart failure group of phase CKD1-5 （P〈0.05）,NT-proBNP/SCr and NT-proBNP/SCys-C significantly decreased as the progress of CKD stage in heart failure group of phase CKD1-5 （P〈0.05）.NT-proBNP/SCr was 〉10.58,NT-proBNP/SCys-C 〉1012.22 in phase CKD1-5.Conclusion NT-proBNP/ SCr,NT-proBNP/SCys-C can be clinical indexes of independently evaluating CKD combined with heart failure,not affected by kidney function.
出处
《国际医药卫生导报》
2015年第14期1989-1991,2004,共4页
International Medicine and Health Guidance News
关键词
慢性肾脏病
心力衰竭
氨基末端
B型脑钠肽前体
血清肌酐
诊断价值
Chronic kidney disease
Heart failure
Amino terminal
B-type brain natriuretic peptide precursor
Serum creatinine
Diagnostic value
