脑钠肽前体对于糖尿病透析患者心功能评价的临床意义

摘要

Objective To detect plasma N - terminal - pro - B - type - natriuretic - peptide changes in diabetic dialysis patients and assess the diagnostic value of NT - proBNP for left ventricular dysfunction. Methods Plasma BNP concentration was measured in 46 dialysis patients. Left ventricular end diastolic diameter ( LVDd) and left ventricular ejection fraction ( LVEF) were determined. The relationship between the levels of plasma NT - proBNP and cardiac function was compared. Results (1) The level of plasma NT - proBNP in diabetic dialysis patients was higher than the levels of plasma NT - proBNP in hemodialysis patients without diabetes. (2) More diabetic dialysis patients are complicated by left ventricular dysfunction than patients without diabetes. The levels of plasma NT - proBNP in diabetic dialysis patients with complicated left ventricular dysfunction were significant higher than patients with normal cardiac function. Conclusions The increase in NT - proBNP concentration can reflect the combination of chronic left ventricular dysfunction in diabetic dialysis patients in a certain extent.%目的 评价脑钠肽前体(N-terminal-pro-B-type-natriuretic-peptide,NT-proBNP)对于糖尿病血液透析患者心功能不全的临床诊断意义.方法 检测46例血液透析患者血浆NT-proBNP水平,其中糖尿病19例.采用心脏超声测定46例左室舒张末内径(LVDd)及左室射血分数(LVEF),分析糖尿病透析患者血浆NT-proBNP水平与其心脏功能的关系.结果 (1)糖尿病组透析间期血浆NT-proBNP浓度[(8627.2±5958.1) pg/ml]明显高于非糖尿病组[(3585.5±1455.1) pg/ml],差异有统计学意义(P＜0.05);(2)糖尿病组左心室扩大比例高于非糖尿病组.糖尿病组中,合并左室扩大的患者血浆NT-proBNP[(11 756.2±6928.7) pg/ml]浓度明显高于不合并左室扩大的患者[(4910.4±2480.2) pg/ml],差异有统计学意义(P＜0.05).结论 血浆NT-proBNP浓度升高在一定程度上可反映糖尿病血液透析患者存在左心功能障碍.