摘要
目的分析维持性血液透析(MHD)患者血浆心肌酶学、氨基末端脑钠肽前体(NT-proBNP)和血肌酐(SCr)水平变化与心功能衰竭的相关性。方法选取我院行MHD治疗患者100例(MHD组),根据是否并发心力衰竭(HF)分为MHD并发HF组33例和MHD未并发HF组67例;同期健康体检者40例(健康对照组),非透析CKD患者40例(CKD对照组)。检测患者血浆肌酸激酶同工酶(CK-MB)、NT-proBNP、SCr水平及心脏每搏量(SV)、左室射血分数(LVEF)等心功能指标,计算左心室心肌质量指数(LVMI)。分析MHD患者CK-MB、NT-proBNP及SCr水平与心功能之间的相关性,采用受试者工作特征(ROC)曲线评估各项指标在HF预测中的应用价值。结果健康对照组、CKD对照组、MHD未并发HF组及MHD并发HF组的CK-MB、NT-proBNP、Scr、LVMI水平依次递增,SV、LVEF水平依次递减(P<0.05)。CK-MB、NT-proBNP及SCr水平均与SV、LVEF指标呈负相关,与LVMI指标呈正相关(P<0.05)。CK-MB、NT-proBNP及SCr用于预测MHD患者伴发HF的AUC分别为0.802、0.878、0.740,NT-proBNP的AUC值显著高于SCr(P<0.05)。结论MHD并发HF患者的血浆CK-MB、NT-proBNP及SCr水平均明显升高,且与患者的心功能指标关系密切,检测上述指标对于预测MHD患者并发HF具有积极意义。
Objective To analyze the changes in levels of plasma myocardial enzymes,N-terminalpro-B-type natriuretic peptide(NT-proBNP)and serum creatinine(SCr)in patients undergoing maintenance hemodialysis(MHD)and their correlations with heart failure(HF).Methods A total of 100 MHD patients admitted to our hospital were enrolled as MHD group.According to presence or absence of HF,they were divided into HF group(n=33)and non-HF group(n=67).A total of 40 healthy controls during the same period were enrolled as healthy control group,and other 40 non-dialysis patients with CKD were enrolled as CKD control group.The levels of plasma creatine kinase-MB(CK-MB),NT-proBNP and SCr,and cardiac function indexes such as stroke volume(SV)and left ventricular ejection fraction(LVEF)were detected.The left ventricular mass index(LVMI)was calculated.The correlation between the levels of CK-MB,NT-proBNP and SCr and the cardiac function in the MHD patients was analyzed.The application value of different indexes in HF prediction was evaluated by receiver operating characteristic(ROC)curve.Results The levels of CK-MB,NT-proBNP and Scr were increased sequentially while the levels of SV and LVEF were decreased successively from healthy control group,CKD control group,non-HF group to HF group(P<0.05).The levels of SV and LVEF in the HF group were significantly lower than those in the non-HF group,and LVMI was significantly higher than that in the non-HF group(P<0.05).The levels of CK-MB,NT-proBNP and SCr were negatively correlated with SV and LVEF while positively correlated with LVMI(P<0.05).ROC analysis results showed that AUC values of CK-MB,NT-proBNP and SCr for predicting HF in MHD patients were 0.802,0.878 and 0.740,respectively.TheAUC of NT-proBNP was significantly higher than that of SCr(P<0.05).Conclusion The levels of plasma CK-MB,NT-proBNP and SCr are significantly increased in patients with MHD complicated withHF.The plasma indexes are closely related to cardiac function indexes.The detection of the indexes is of positive significance for predicting HF in MHD patients.
作者
漆星
林胜
张文忠
杨君华
郭琴
张瑶琳
王华国
QI Xing;LIN Sheng;ZHANG Wen-zhong;YANG Jun-hua;GUO Qin;ZHANG Yao-lin;WANG Hua-guo(Department of Laboratory Medicine,Ziyang First People's Hospital,Ziyang 641300,China;Department of Nephrology,Ziyang First People's Hospital,Ziyang 641300,China)
出处
《实用医院临床杂志》
2021年第4期204-207,共4页
Practical Journal of Clinical Medicine
关键词
维持性血液透析
心肌酶
氨基末端脑钠肽前体
血肌酐
心功能衰竭
Maintenance hemodialysis
Myocardial enzyme
N-terminal pro B type natriuretic peptide
Serum creatinine
Heart failure
