血浆脑钠肽在评估血液透析患者干体重中的应用价值

摘要

目的:观察血液透析(HD)患者调整干体重前后血浆脑钠肽(BNP)水平的变化,探讨BNP评估HD患者干体重的应用价值.方法:根据透析患者胸部X线片心胸比(CRT)、血压、下腔静脉内径(IVCD)、评估50例血液透析患者干体重,将患者分为干体重未达标组(A组)与达标组(B组)各25例,且将A组经过4周逐渐增加透析脱水量下调干体重达到临床干体重(D组).同时选取25名健康体检合格成人作为对照组(C组),测定血压、CRT、IVCD/体表面积(VCD)、BNP等数值.结果:A组BNP、CRT和VCD水平均显著高于B、C和D组(P＜0.01),B、C和D组BNP、CRT和VCD水平差异均无统计学意义(P＞0.05),且A组患者干体重调节前后BNP水平变化和VCD值、CRT之间均呈正相关关系(P＜0.01).结论:BNP作为HD患者超水平负荷的指标,评估干体重有一定价值.%Objective: To observe the plasma brain natriuretic peptid ( BNP) levels of hemodialysis ( HD ) patient before and after adjustment of dry weight and explore its value in evaluating dry weight. Methods: Fifty HD patients were divided into group A ( no-reaching the dry weight standard, 25 cases) and group B ( reaching the dry weight standard, 25 cases) according to the dry weight evaulated by cardiac thoracic rate (CRT) , blood pressure, body weight and the inferior vena cava width(IVCD). The dry weight of partial patients from group A were adjusted to reach the clinical dry weight by increasing the dialysis dehydrated level for 4 weeks, which was divided into group D. Twenty-five healthy persons were divided into group C(control group) ,which blood pressure, CRT, VCD and BNP were measured. Results: The levels of BNP, CRT and VCD of group A were significantly higher than that of group B, C and D( P 0. 05 ) . BNP level changes of group A before and after adjustment of dry weight were positively related to its value of VCD and CRT( P < 0. 01) . Conclusions: BNP can be used as the water load index of HD patients, which has a certain value to assess dry weight.