中国血液净化

中国血液净化 ›› 2016, Vol. 15 ›› Issue (02): 68-71.doi: 10.3969/j.issn.1671-4091.2016.02.003

• 临床研究 • 上一篇    下一篇

应用生物电阻抗法评估维持性血液透析患者NT-proBNP差值与体液成分的关系

李杰,张启蒙,付旭,刘京,王尊理,郝丽   

  1. 北京市中关村医院血液净化中心
  • 收稿日期:2015-10-15 修回日期:2015-12-07 出版日期:2016-02-12 发布日期:2016-02-19
  • 通讯作者: 李杰 lj740624@163.com E-mail:lj740624@163.com

The correlation between the changes of serum NT-proBNP after hemodialysis and the body fluid distribution evaluated by whole-body bioimpedance spectroscopy in maintenance hemodialysis patients

  • Received:2015-10-15 Revised:2015-12-07 Online:2016-02-12 Published:2016-02-19

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摘要： 目的应用多频生物电阻抗的方法测量维持性血液透析(maintenance hemodialysis，MHD)患者透析前、后体液分布情况，再与透析前、后NT-proBNP 的差值作比较，来探讨NT-proBNP 差值与体液分布的关系。方法应用多频生物电阻抗测定84 例透析患者透析前后MHD 患者的体内水含量及分布，同时抽血测定其NT-proBNP 值。计算透析前、后N 末端脑钠肽前体(N-termind pro-brain natriuretic peptide,NT-proBNP)差值。应用相关分析各个指标之间的关系。结果透析前血清NT-proBNP 与透析前身体水分总量(total water,TBW)、细胞外液(extracellular water，ECW)、细胞内液(intracellular water，ICW)、ECW/TBW 无明显的相关性。透析后血清N 末端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)与透析后ECW/TBW(r=0.251，P=0.025)呈正相关，与ICW 呈显著的负相关
(r=- 2.333，P=0.037)。相关分析显示MHD 患者透析前、后血清NT- proBNP 的差与ECW(r=- 0.235，P= 0.036)、ECW/TBW(r=-0.252，P=0.024)、ECW/ICW(r=-0.228，P =0.042)呈显著负相关，与TBW(r=-0.121，P=0.284)和ICW(r=0.018，P =0.871)无明显的相关性。结论NT-proBNP 差值与MHD 患者透析前后患者体液分布有较好的一致性，可以用于评价MHD患者的容量负荷。

关键词: 多频生物电阻抗, NT-proBNP, 差值, 血液透析

Abstract: Objective To evaluate the significance of N- terminal pro- brain natriuretic peptide (NTproBNP) changes after a hemodialysis session in the assessment of body fluid distribution by comparing these changes with the values from whole-body bioimpedance spectroscopy in maintenance hemodialysis (MHD)patients. Method Whole-body bioimpedance spectroscopy and serum NT-proBNP were measured before and after hemodialysis sessions in 84 MHD patients. Body fluid content and distribution calculated from whole- body bioimpedance spectroscopy and the changes of NT- proBNP were compared in these patients. Results Before hemodialysis, serum NT- proBNP was insignificantly correlated with total body water (TBW), extracellular water (ECW), intracellular water (ICW) and ECW/TBW. After hemodialysis, serum NTproBNP was positively correlated with ECW/TBW (r=0.251, P=0.025), and negatively correlated with ICW (r=-2.333, P=0.037). Correlation analyses also demonstrated that the changes of serum NT-proBNP after hemodialysis were negatively correlated with ECW (r=-0.235, P=0.036), ECW/TBW (r=-0.252, P=0.024) and ECW/ICW (r=-0.228, P=0.042), but had no correlations with TBW (r = -0.121, P = 0.284) and ICW (r = 0.018, P = 0.871). Conclusion The changes of serum NT-proBNP after hemodialysis were comparable with the changes of water distribution after hemodialysis, which may provide a new approach for the evaluation of volume overload in MHD patients.

Key words: multi-frequency bioimpedance analysis, N-terminal pro-brain natriuretic peptide, difference, hemodialysis