中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (06): 445-449.doi: 10.3969/j.issn.1671-4091.2014.06.007

• 临床研究 • 上一篇    下一篇

B型脑钠肽评估维持性血液透析患者容量负荷的临床研究

郑洁,李秀季,丁宁,黄雯   

  1. 首都医科大学附属北京同仁医院肾内科
  • 收稿日期:2013-08-22 修回日期:2014-04-10 出版日期:2014-06-12 发布日期:2014-06-12
  • 通讯作者: 黄雯 huangw@trhos.com E-mail:trhuangwen@163.com

Value of plasma B-type natriuretic peptide in assessing fluid overload in hemodialysis patients

  • Received:2013-08-22 Revised:2014-04-10 Online:2014-06-12 Published:2014-06-12
  • Contact: HUANG Wen E-mail:trhuangwen@163.com

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摘要： 【摘要】目的：探讨B型脑钠肽（B-type natriuretic peptide，BNP）与维持性血液透析患者（maintenance hemodialysis，MHD）患者容量负荷关系的临床意义。方法：选择我院血液透析中心MHD患者87例，根据BNP水平从低到高低将患者分为4组，观察BNP水平变化与容量负荷变化之间的关系。结果：BNP最低组，3个月后透析后体重、BNP水平较前无明显变化（p＞0.05）；BNP较高组，患者透析后体重、BNP水平均较前明显下降（p＜0.05）；各组之间患者透析后体重变化、BNP变化有显著差别（p＜0.001）。MHD患者基础BNP水平越高，透析后体重下降越明显，BNP水平与透析后体重下降呈正相关（R=0.763，p＜0.001）。患者透析前收缩压变化、透析后体重变化、白蛋白及血红蛋白水平变化与MHD患者血浆BNP水平变化相关（R=0.740，R2=0.507）。BNP评估MHD患者透析后体重变化的ROC曲线下面积为0.918（p＜0.001）。结论：BNP可作为临床上评估MHD患者容量负荷增加的一个有效参考指标。

关键词: B型脑钠肽, 血液透析

Abstract: 【Abstract】 Objective To explore the value of plasma B-type natriuretic peptide in assessing fluid volume in hemodialysis patients. Methods Eighty-seven hemodialysis patients were divided into four groups according to the plasma BNP level. The relationship between plasma BNP level and post-dialysis body weight of MHD patients was analyzed. Results The plasma BNP level and post-dialysis body weight decreased significantly in groups with higher plasma BNP level（p＜0.05）. There was significant difference of BNP and post-dialysis body weight among different groups. The baseline plasma BNP level was positively correlated with decreasing of post-dialysis body weight（R=0.763，p＜0.001）. The changes of post-dialysis body weight, systolic BP, albumin and hemoglobin were correlated with the change of plasma BNP（R=0.823，R2=0.678）.The area under ROC curve was 0.918（p＜0.001）. Conclusions The plasma BNP level could be the effective index to determine chronic volume overload in hemodialysis patients.

Key words: B-type natriuretic peptide, Hemodialysis