摘要
目的B型脑钠肽（BNP）及体表面积矫正后下腔静脉宽度（VCD）对稳定血液透析患者的干体重的评估。方法检测58例维持性血液透析患者透析前后血浆BNP水平，同时应用彩色多普勒超声心动图测定透析前和透析后2h的下腔静脉宽度，检测透析前、后心脏结构及功能变化，记录当次透析脱水量。透析前、透析后及健康对照组对上述指标进行比较。结果58例稳定透析患者经透析脱水后血浆BNP水平（52．1±22．8）ng／L较透析前（156．5±18．2）ng／L显著下降，但仍较健康对照组（15．6±7．6）ng／L增高（P〈0．01）。VCD值透析后（9．8±2．1）mm／m^2较透析前（13．3±3．1）mm／m^2显著下降但与健康对照组（9．1±1．1）mm／m^2比较差异无统计学意义。应用超声影像学及，临床指标，对透析后患者判断仍存在高血容量者8例，血浆BNP[（224．1±42．8）ng／L]及VCD[（12．8±2．1）mm／m^2]显著增高，降低干体重后，BNP[（38．4±8．6）ng／L]及VCD[（9．7±1．4）mm／m^2]值显著下降。结论血浆BNP及VCD在一定程度上反映血液透析患者体内血容量的变化，是判断干体重有价值的参考指标。
Objective To observe the significance of brain natriuretic peptide （BNP） and vena caval diameter（VCD） on evaluation of the dry body weight in patients undergone hemodialysis. Methods Plasma BNP concentration and VCD were measured in 58 maintained hemodialysis patients before and after hemodialysis and in 32 healthy control subjects. The VCD before and 2 h after dialysis was detected by color Doppler, heart structure and function changes were monitored, and the dehydration volume was recorded in every dialysis. The changes of these indicators were compared. Results The plasma BNP concentrations in 58 patients after hemodialysis were significantly lower than before hemodialysis[ （52.1 ±22.8）ng/L vs （ 156.5 ± 18.2）ng/L] but higher than that of healthy controis [ （ 15.6 ± 7.6）ng/L ] （P 〈 0.01 ）. VCD was significantly decreased as compared with that before hemodialysis [ （ 9.8 ± 2.1 ） mm/m^2 vs （ 13.3 ± 3.1 ） mm/m^2 ], without significantly difference with healthy controls [ （9.1 ± 1.1 ） mm/m^2 ]. In the overload of 8 patients evaluated by regular clinical methods,the plasma BNP and VCD[ （224.1 ± 42.8） ng/L and （ 12.8 ± 2.1 ） mm/m^2 ] were significantly higher than that before dialysis, which decreased with lowering the dry body weight[ （38.4 ± 8.6） ng/L and （9.7 ± 1.4） mm/m^2 ]. Conclusion The plasma BNP concentration and VCD are sensitive indicators of liquid overload, and may be used to evaluate the dry weight in hemodialysis patients.
出处
《中国综合临床》
2009年第1期81-83,共3页
Clinical Medicine of China
关键词
血液透析
脑钠肽
下腔静脉宽度
干体重
Hemodialysis
Brain natriuretic peptide
Inferior vena caval diameter
Dry body weight
