腹膜透析患者血清NT-proBNP与容量状态及心功能指标的相关分析

发布时间：2018-03-31 16:53

  本文选题：腹膜透析　切入点：NT-proBNP　出处：《广西医科大学》2014年硕士论文

【摘要】：目的探讨持续性不卧床腹膜透析（CAPD）患者的血清脑钠肽前体（NT-proBNP）水平与患者容量状态及心功能指标的关系，分析影响NT-proBNP的相关因素。 方法测定104例腹膜透析患者及30例健康对照组血清中的NT-proBNP值并相互比较，根据腹膜平衡试验将CAPD患者分为不同腹膜转运类型，分析不同转运类型患者的NT-proBNP水平的差异，及其与其它容量负荷及心功能指标的相互关系，探讨影响腹透患者血清NT-proBNP的相关因素，并评估其临床意义。 结果CAPD患者的NT-proBNP水平与对照组相比明显增高，差异有统计学意义；不同腹膜转运类型腹透患者的NT-proBNP水平比较，组间差异有统计学意义，CAPD患者的NT-proBNP水平与其腹膜转运类型呈正相关，高转运类型的腹透患者NT-proBNP水平升高最明显，，低转运类型患者的NT-proBNP水平升高幅度相对最少（P0.05)。每日尿量＞100ml的CAPD患者血清NT-proBNP总体水平明显低于每日尿量≤100ml患者，差异有统计学意义（F=5.744，P=0.018）；患者总Kt/V≥1.7患者的血清NT-proBNP总体水平低于总Kt/V＜1.7患者，差异无统计学意义（P＞0.05）；总Ccr≥50L/周患者的血清NT-proBNP总体水平低于总Ccr＜50L/周患者，差异无统计学意义（P＞0.05）。NT-proBNP水平与水肿、收缩压升高、摄入量、血肌酐、心胸比例、心影增大、LVEDD、LVESD、LVST及LAD呈正相关，与年龄段、残肾KT/V、残肾Ccr、Hb、Alb、Ca及LVEF呈负相关。 结论CAPD患者的NT-proBNP水平普遍升高，且在不同腹膜转运类型组及不同尿量组之间存在差异，并与血容量负荷评估的有效指标密切相关，与残余肾功能、贫血及营养状态也存在一定的相关性。
[Abstract]:Objective to investigate the relationship between the serum NT-proBNPs and the volume status and cardiac function in patients with continuous ambulatory peritoneal dialysis (PD) and to analyze the related factors affecting NT-proBNP. Methods Serum NT-proBNP levels in 104 patients with peritoneal dialysis and 30 healthy controls were measured and compared. According to peritoneal balance test, CAPD patients were divided into different types of peritoneal transport, and the difference of NT-proBNP levels in patients with different transport types was analyzed. To explore the related factors of serum NT-proBNP in patients with peritoneal dialysis and its relationship with other indexes of volume load and cardiac function, and to evaluate its clinical significance. Results the level of NT-proBNP in CAPD patients was significantly higher than that in the control group, and the NT-proBNP level in patients with different peritoneal transport types was significantly higher than that in the control group. There was a positive correlation between the NT-proBNP level and the peritoneal transport type in CAPD patients. The NT-proBNP level in patients with high transport type was significantly higher than that in patients with high transport type. The level of NT-proBNP in patients with low transport type was significantly lower than that in patients with daily urine volume 鈮

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