心肾综合征患者心脏结构功能、BNP、Cys－C变化与CKD分期的相关性

摘要

Objective:To explore the relationship between the staging of chronic kidney disease ( CKD) and changes of heart structure and brain natriuret-ic peptide(BNP) and cystatin C(Cys-C) in patients with cardiorenal syndrome(CRS).Methods:Total of 84 eligible patients with CKD were included be -tween January 2011and June 2012.All patients were undergone determination of whole blood BNP and cys -C levels as well as echocardiogram and electro-cardiogram examination at admission.The data were gathered for analysis of the relationship among the indicators .Rseult s:Of the patients in stage of CKD 3,4 and 5,the BNP and cys-C levels,left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPW),and flow velocity at peak E and E/A ratio were statistically different(P<0.01).Conclusion:CRS patients in stage CKD 3 to 5 primarily demonstrated LVDd change and thickened posterior left ventricular wall and diastolic function impairment .Combined determination of whole blood BNP and cys-C with echocardiogram and electrocardiogram examination may be effective indicators for prevention and early treatment of this disease .%目的：探讨心肾综合征（ cardiorenal syndrome ， CRS ）患者超声心动图变化及全血脑钠肽（ brain natriuretic peptide ， BNP）、胱抑素C（Cystatin C，Cys－C）水平等与慢性肾脏病（chronic kidney disease，CKD）分期的关系。方法：我院肾内科符合标准的84例CRS患者，检测入院时的全血BNP、Cys－C水平，并检测超声心动图及心电图，收集相关参数进行分析。结果：CKD3、45、期CRS患者之间，全血BNP、Cys－C水平有显著差异，各组之间左室舒张末期内径（ LVDd）、左室后壁厚度（ LVPW）、E峰、E／A、心率差异有统计学意义（ P＜0．05），而BNP和LVDd与CKD分期的相关性更加密切。结论：CKD 3～5期CRS患者心脏结构改变主要表现在左室舒张末期内径、左室后壁厚度增加等，心功能障碍主要表现在舒张功能受累。联合全血BNP、Cys－C水平、超声心动图及心电图检查可以作为观察CRS病情的有效指标，有利于预防及早期治疗。