尿毒症患者血浆脑钠肽水平变化及与心功能的关系研究

摘要

Objective To observe the changes of plasma brain natriuretic peptide(BNP)level of uremia patients,to investigate its correlation with cardiac function. Methods A total of 72 uremic patients admitted to Lianyungang Hospital Affilia­ ted to Xuzhou Medical College were collected from June 2012 to December 2013,and they were divided into groups A(NYHA cardiac function grading at Ⅱ,n ﹦ 27),B(NYHA cardiac function grading at Ⅲ,n ﹦ 25),C(NYHA cardiac function grad­ ing at Ⅳ,n ﹦ 20)according to NYHA cardiac function grading,the plasma BNP level,ejection fraction and serum creatinine level among the three groups were compared. All of the patients given dialysis treatment,the plasma BNP level,ejection fraction and serum creatinine level before dialysis(T1),the second day after three times of dialysis(T2),the second day after 4 weeks of dialysis(T3)were compared. Results There was no significant differences of serum creatinine level among the three groups (P > 0. 05);plasma BNP level of B group and C group was significantly higher,ejection fraction was significantly lower than that of A group,respectively(P < 0. 05);plasma BNP level of C group was significantly higher,ejection fraction was signifi­ cantly lower than that of B group,respectively(P < 0. 05). Plasma BNP level,serum creatinine level of all of the patients at T2 and T3 was lower,ejection fraction was higher than that of at T1,respectively(P < 0. 05);plasma BNP level,serum creat­ inine level of all of the patients at T3 was lower,ejection fraction was higher than that of at T2,respectively(P < 0. 05). Con­ clusion The worse of cardiac function of uremia patients,the higher of plasma BNP level,and dialysis treatment can improve the cardiac function,reduce the plasma BNP level.%目的：观察尿毒症患者血浆脑钠肽水平变化，探讨其与心功能的关系。方法收集徐州医学院附属连云港医院肾内科2012年6月—2013年12月收治的新发尿毒症患者72例，根据纽约心脏病协会（NYHA）心功能分级分为Ⅱ级组27例，Ⅲ级组25例，Ⅳ级组20例，比较3组患者血浆脑钠肽水平、射血分数、血肌酐水平。所有患者进行透析治疗，比较透析前、透析3次后次日、透析4周后次日血浆脑钠肽水平、射血分数、血肌酐水平。结果3组患者血肌酐水平比较，差异无统计学意义（P ＞0.05）；Ⅲ级组、Ⅳ级组患者血浆脑钠肽水平高于Ⅱ级组、射血分数低于Ⅱ级组，Ⅳ级组患者血浆脑钠肽水平高于Ⅲ级组、射血分数低于Ⅲ级组（P ＜0.05）。所有患者透析3次后次日、透析4周后次日血浆脑钠肽水平、血肌酐水平低于透析前，射血分数高于透析前，透析4周后次日血浆脑钠肽水平低于透析3次后次日，射血分数高于透析3次后次日（P ＜0.05）。结论尿毒症患者心功能越差，血浆脑钠肽水平越高，透析治疗可明显改善尿毒症患者心功能，降低血浆脑钠肽水平。