摘要
目的研究慢性肾脏疾病(CKD)非透析患者脑钠素与肾功能及左室肥厚的关系。方法采用双抗夹心免疫荧光法检测203例 CKD 非透析患者与16例对照组全血脑钠素(BNP)水平,分析其与肾功能及左室心肌重量指数(LVMI)的关系。结果 BNP 水平随着肾小球滤过率(eGFR)的下降逐渐递增[9.35(7.35-15.00)v8 54.40(15.10-173.00)ng/L,P<0.01],Spearman 相关分析提示 CKD 患者 BNP 水平和 eGFR 呈负相关(r=-0.417,P<0.01)。多重回归分析显示 eGFR是影响 BNP 水平的独立危险因素(β=-0.293,P<0.01),lgGFR 每降低1 ml·min^(-1)·(1.73m^2)^(-1),lgBNP 水平就上升0.293 ng/L。CKD 非透析患者与对照组相比左室肥厚发生率明显上升(53.2%vs 10.0%,P<0.05),存在左室肥厚的患者血 BNP 水平显著升高[93.05(37.70-272.00)vs17.30(7.20-63.70)ng/L,P<0.01],LVMI 也是影响 BNP 水平高低的主要原因之一(B=0.266,P<0.01),lgLVMI 每升高1g/m^2,lgBNP 水平就上升0.266 ng/L。结论在 CKD 非透析患者中,eGFR 下降可上调 BNP 水平,虽然肾功能不全可部分干扰 BNP 浓度,但是左室肥厚仍可作为一项影响 BNP 水平升高的独立危险因素。
Objective To clarify the association of brain natriuretic peptide ＊ BNP） with renal function and cardiac dysfunction in non-dialysis-dependent patients with chronic kidney disease （CKD）. Methods Fluorescence immuno-assay was used to detect the whole blood concentration of BNP in a cohort of 203 CKD patients and 16 hypertensive controls. Color ultrasonography was conducted to determine the left ventricular mass index （LVMI）. Estimated glomerular filtration rate （eGFR） was examined. The relationship of BNP to eGFR and LVMI in these patients. Results There was a trend that the BNP level increased with the decrease of the level of eGFR [ 9.35 （7.35-15.00） vs 54.40 （15.10-173.00） ng/L, P 〈 O. O1 ]. Spearman correlation showed that BNP level was correlated negatively with eGFR（r = -0.417 ,P 〈 0.01 ）. Multiple regression analysis showed that eGFR was the independent determinant of BNP （β= -0.293, P 〈0.01 ）, and lgBNP concentration increased by 0. 293 ng/L per 1ml·min^-1·（1.73m^2）^-1 reduction in lgGFR. The incidence of LV hypertrophy was much higher in the CKD patients than in the controls （53.2% vs 10.0% ,P 〈0.05 ）. BNP level was greater in the patients with LV hypertrophy [93.05 （37.70-272.00） vs 17.30（7.20-63.70） ng/L, P 〈0.01 ], and LVMI had an independent effect on BNP concentration （β= 0.266, P 〈 0.01 ）. lgBNP level increased by 0.266 ng/L per 1 g/m^2 increase in lgLVMI. Conclusion The declining eGFR level independently elevates the BNP level in non-dialysis-dependent CKD patients. Although renal dysfunction itself may affects the BNP concentration, LV hypertrophy is a powerful independent determinant of BNP.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2007年第46期3284-3287,共4页
National Medical Journal of China
关键词
利钠肽
脑
肾病
透析
肥大
左心室
Natriuretic peptide, brain
Kidney diseases
Dialysis
Hypertrophy, left ventricular
