血浆N-末端脑钠肽前体水平与维持性血液透析患者容量状态无关

目的 测定维持性血液透析患者生物电阻抗与血浆N-末端脑钠肽前体水平透析前后的变化,评价N-末端脑钠肽前体水平在血透患者中血容量评估的应用价值.方法 选取我院血液净化中心30例病情稳定的维持性血液透析患者,留取透析前后血标本测定N-末端脑钠肽前体.应用生物电阻抗(英国BodyStat公司QUADSCAN 4000多频生物电阻抗分析仪)测量透析前后体水量.结果 透析后N-末端脑钠肽前体水平较透析前明显升高[分别为(6 478.93±7 503.48)与(4 692.83±4 290.62) pg/ml,P＜0.01].透析后身体成分监测值较透析前明显降低[(-0.987± 1.451)与(0.964± 1.581),P＜0.01].结论 N-末端脑钠肽前体的血浆水平与维持性血透患者血容量无关.

Serum level of N-terminal pro brain natriuretic peptide was independent of volume status among hemodialysis patients

Objective To measure the changes of the biological electrical impedance and the serum level of N-terminal pro brain natriuretic peptide (NT-proBNP) in patients under going maintenance hemodialysis(MHD) and to evaluate the application value in blood volume assessment of patients.Methods A total of 30 patients who were treated with MHD for at least 3 months before the study and in a stable clinic status were selected.The dialyzer of patients with maintenance hemodialysis were low flux polysulfone dialyzers (membrane area 1.4-1.6 m2).The serum levels of NT-pro BNP before and after dialysis were measured,and the ultrafiltration volume,body weight before and after dialysis and blood pressure were recorded.Bioelectrical resistance were applicated to measure body water of patients.Results The serum levels of NT-proBNP before and after dialysis in MHD patients were significantly higher than those of nonCKD group (P ＜ 0.01).The serum level of NT-proBNP after dialysis of MHD patients was significantly higher than the serum level of NT-proBNP before dialysis in MHD patients (6 478.93 + 7 503.48) and (4 692.83 + 4 290.62) pg/ml,P ＜ 0.01).Body composition monitor(BCM) after dialysis was significantly decreased than before dialysis((-0.987+1.451)L and(0.964+1.581)L,P＜0.01).Conclusion The serum NT-proBNP level of MHD patients has no conern with blood volume.