血液透析患者心力衰竭与B型脑钠肽的关系分析

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摘要目的分析血液透析患者心力衰竭（HF）与B 型脑钠肽（BNP）的关系。方法选取萍乡市人民医院2019年1月～2020年8月收治的60 例血液透析患者，根据左心室射血分数（LVEF）水平将并发HF 的患者（LVEF＜50%）归为观察组（30 例），将未并发HF 的患者（LVEF≥50%）归为对照组（30 例）。两组入院后均进行LVEF、BNP 水平检测，观察组予以常规抗HF 治疗及慢性肾衰竭一体化治疗，对照组予以常规血液透析以及慢性肾衰竭一体化治疗。记录两组入院时LVEF 水平；对比两组入院时、干预治疗后BNP 水平，分析血液透析患者LVEF 与BNP 水平的关系，并绘制受试者工作特征（ROC）曲线分析BNP 水平对血液透析患者发生HF 的预测价值。结果观察组入院时LVEF 水平低于对照组，差异有统计学意义（P＜0.05）；观察组入院时与治疗后BNP 水平均高于对照组，且观察组治疗后的BNP 水平低于入院时，差异有统计学意义（P＜0.05）；对照组治疗后的BNP 水平与入院时比较，差异无统计学意义（P＞0.05）。相关性分析发现，血液透析患者入院时LVEF 水平与BNP 水平呈负相关（r=-0.806，P＜0.001）。绘制ROC 曲线分析BNP 水平预测血液透析患者HF 发生的曲线下面积为0.952，预测价值较高，对应的最佳阈值为222.35 ng/dL，敏感度为96.70%，特异度为46.70%。结论 BNP 水平可有效判断血液透析患者的HF 进展，临床可根据BNP 水平予以相关干预，改善血液透析患者预后，值得临床推广。

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	刘燕丽
	陈清萍

关键词 ：心力衰竭, 血液透析, B 型脑钠肽, 左心室射血分数, 预测价值

Abstract：Objective To analyze the relationship between heart failure (HF) and B-type brain natriuretic peptide(BNP) in patients with hemodialysis.Methods From January 2019 to August 2020, a total of 60 new found of patients with hemodialysis in Pingxiang People′s Hospital were selected, according to the left ventricular ejection fraction(LVEF) levels, patients with HF (LVEF＜50%) were classified as the observation group (30 cases), and those without HF(LVEF≥50%) were classified as the control group (30 cases).Both groups were tested for LVEF, BNP levels after admission,the observation group was received conventional anti-HF treatment and integrated treatment of chronic renal failure,and the control group was received conventional hemodialysis and integrated treatment of chronic kidney disease.LVEF levels of the two groups at admission were recorded; the BNP levels of the two groups at admission and after intervention treatment were compared.The relationship between LVEF and BNP levels in patients with hemodialysis were analyzed,and a receiver operating curve(ROC)curve was drawn to analyze the predictive value of BNP levels for HF in patients with hemodialysis.Results LVEF level of observation group at admission was lower than that of control group, the difference was statistically significant(P＜0.05);the BNP levels of observation group at admission and after treatment were higher than those of control group, and the BNP level of the observation group after treatment was lower than that at admission, the differences were statistically significant (P＜0.05); the BNP level after treatment in the control group was compared with that at admission, the difference was not statistically significant (P＞0.05).Correlation analysis showed that LVEF level was negatively correlated with BNP level at admission (r=-0.806，P＜0.001).The ROC curve was drawn and analyzed that the BNP level predicted the area under the curve of HF in patients with hemodialysis was 0.952,which had high predictive value, the corresponding optimal threshold was 222.35 ng/dL, the sensitivity was 96.70%,and the specificity was 46.70%.Conclusion The level of BNP can effectively judge the progress of HF in patients with hemodialysis.High level of BNP is an influencing factor of HF in patients with hemodialysis.Clinical interventions can be made in advance based on the level of BNP to improve the prognosis of patients.It is worthy of clinical promotion.

Key words： Heart failure Hemodialysis B-type brain natriuretic peptide Left ventricular ejection fraction;Predictive value

基金资助:江西省萍乡市科技计划项目（2019PY022）

作者简介: 刘燕丽（1990-），女，江西萍乡人，硕士，主治医师，研究方向：血液透析和腹膜透析

引用本文:

刘燕丽；陈清萍. 血液透析患者心力衰竭与B型脑钠肽的关系分析[J]. 中国当代医药, 2021, 28(10): 63-66.
LIU Yan-li ；CHEN Qing-ping. Analysis of the relationship between heart failure and B-type brain natriuretic peptide in patients with hemodialysis. 中国当代医药, 2021, 28(10): 63-66.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I10/63

[1]	张烨，汪聪，严良烽，等.高通量血液透析对同型半胱氨酸及N 型末端脑利钠肽前体的影响[J].中国当代医药，2019，26（19）：97-99.
[2]	张健瑜，许兆延，梁茜，等.重组脑钠肽治疗顽固性心力衰竭的疗效及对血流动力学、心功能的影响[J].中国老年学杂志，2017，37（22）：5585-5587.
[3]	程燃，何云燕，张佳星.心力衰竭患者血清脑钠肽、同型半胱氨酸和血脂联合检测的临床意义[J].重庆医学，2017，46（18）：2483-2485.
[4]	郑普.血浆BNP 水平在慢性心衰的诊断、病情及预后评估中的应用价值[J].重庆医学，2017，46（A01）：223-224.
[5]	中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志，2007，35（12）：1076-1095.
[6]	韩芬，杨晓，王运登，等.N-端脑钠肽前体与炎症因子在心力衰竭合并肺部感染患者中的临床意义[J].中华医院感染学杂志，2018，28（4）：499-503.
[7]	李俐，肖俊会，毕健成，等.老年慢性心力衰竭患者血浆BNP，TNF-α 和血清cTnI 水平与心室重构指标及心功能的相关性[J].中国老年学杂志，2019，39（5）：1031-1034.
[8]	于庆飞，张磊，刘超，等.血液透析患者肌钙蛋白T、N-末端脑钠肽联合心脏超声检查的临床意义[J].实用医学杂志，2017，33（14）：2424-2425.
[9]	李开斌，谭微，唐雪莲，等.维持性血液透析对老年慢性肾衰竭竭合并心力衰竭患者心脏功能及血浆NT-proBNP的影响[J].河北医药，2017，39（17）：2667-2669.
[10]	朱丽，甘良英，蔡美顺，等.维持性血液透析患者透析前后体液分布特点及与血压、左心室肥厚相关性分析[J].中国血液净化，2018，17（8）：514-518.
[11]	李慧娣，向定成，张金霞，等.不同部位AMI 患者发病48h 内血浆BNP 水平变化及其对近期并发心力衰竭的预测价值[J].山东医药，2017，57（31）：17-20.
[12]	邓承慧，钟麟，王慧清，等.老年血液透析合并心力衰竭患者血清嗜铬粒蛋白A 与B 型钠尿肽和心功能分级的关系[J].中华老年心脑血管病杂志，2019，21（2）：160-163.
[13]	李丹，谷学梅.血液透析用于慢性肾功能衰竭合并急性心力衰竭临床治疗的价值评价[J].陕西医学杂志，2018，47（9）：1161-1163.
[14]	李富强.血液透析和腹膜透析对慢性肾衰竭竭尿毒症患者微炎症状态的影响及与心血管疾病的关系[J].临床内科杂志，2019，36（11）：748-750.
[15]	邓承慧，张宇.青中年血液透析合并心力衰竭患者血清嗜铬粒蛋白A 与B 型脑钠尿肽和心功能分级的关系[J].海南医学，2019，30（16）：2051-2054.