慢性肾衰竭患者血浆NT—proBNP水平的研究

目的探讨慢性肾衰竭患者血浆脑钠肽前体N末端片段（N—terminal-pro—brain natriuretic prptide，NT-proBNP）水平与慢性肾功能不全之间的关系。方法选择临床诊断慢性肾衰竭患者59例，根据肾小球滤过率将患者分为氮质血症期25例、肾衰竭期20例、尿毒症期14例，对照组20例。检测血浆NT—proBNP水平、测量超声心动图并收集患者临床资料。对比不同肾功能状态患者的血浆NT—proBNP水平差异及其与肾功能损害等临床指标及心脏结构功能改变之间的相关性。结果慢性肾衰竭各期患者血浆NT-proBNP水平明显升高，且与左心室后壁厚度、血磷水平正相关，与左室射血分数呈负相关。结论慢性肾衰竭患者血浆NT-proBNP水平升高，其浓度与患者心脏结构和功能的改变以及肾功能下降有关。血浆NT-proBNP水平可作为慢性肾衰竭患者心血管疾病的生化指标。

Level of plasma N-terminal-pro-brain natriuretic peptide in the patients with chronic renal failure

Objective To discuss the relation between plasma N-terminal proBNP（NT proBNP） concentrations and clinical variables in the patients with chronic renal failure（CRF）. Method Plasma NT-proBNP concentrations and UCG were measured in the normal control group（n = 20） and 59 patients with CRF including azotemia （n = 25）,renal failure（n = 20） and uremia（n = 14） , and clinical data were collected. The differences of plasma NT proBNP concentration and its relation with the clinical indexes of renal damage and the change of cardiac structure and function were compared among patients with different renal functions. Result Plasma NT-proBNP concentrations were elevated in each CRF group. Both LVPW（ P〈0. 0005） and serum phosphate concentration（P= 0. 001） had an independent effect on plasma NT-proBNP concentrations. The EF（P = 0. 007） was negatively related to the plasma NT-proBNP concentrations. Conclusion The concentrations of plasma NT-proBNP were elevated in CRF patients. The cardiac structure and function have independent effects on NT-proBNP concentrations in patients with CRF. NT proBNP appears to be affected by declined renal function. NT-proBNP may be used as a biomarker of cardiovascular disease in patients with CRE.