终末期肾病维持性血液透析患者cTnT、BNP水平检测及其预后分析

目的探讨终末期肾病维持性血液透析患者血清肌钙蛋白(cTnT)、B型钠尿肽(BNP)水平检测与其预后的关系,为患者的临床诊治提供理论依据。方法选取2018年1月-2019年1月在上海曲阳医院就诊的维持性血液透析患者41例为观察组,选取非透析终末期肾病患者41例为对照组。记录两组患者cTnT、BNP超声心动图异常变化情况,比较两组患者死亡发生率及临床资料,分析探讨维持性血液透析患者cTnT、BNP水平检测及其预后的关系。结果观察组患者的收缩压、血肌酐/尿素氮水平均明显高于对照组,差异有统计学意义(P<0.05)。cTnT阴性组患者的超声心动图检测异常发生率(23.52%)明显低于cTnT阳性组患者(58.33%),差异有统计学意义,BNP阴性组患者的超声心动图检测异常发生率(27.78%)明显低于BNP阳性组患者(60.87%),差异有统计学意义(P<0.05)。cTnT阴性组患者的死亡率(11.76%)明显低于cTnT阳性组患者(41.67%),BNP阴性组患者的死亡率(16.67%)明显低于BNP阳性组患者(47.83%),差异有统计学意义(P<0.05)。相关性分析发现,cTnT、BNP水平与患者的预后呈正相关。结论 cTnT、BNP水平与患者的预后呈正相关,上述两种指标的检测能有效改善终末期肾病维持性血液透析患者的预后,降低其病死率,值得临床中用于患者生存的评估。

Detection of cTnT and BNP Levels and Analysis of Prognosis in Patients with Maintenance Hemodialysis of End-stage Renal Disease

OBJECTIVE To investigate the relationship between serum troponin(cTnT)and B-type natriuretic peptide(BNP)levels and prognosis in patients with end-stage renal disease maintenance hemodialysis,to provide theoretical basis for the clinical diagnosis and treatment of patients. METHODS 41 patients with maintenance hemodialysis patients who were admitted to target hospital from January 2018 to January 2019 were selected as observation groups, 41 patients with non dialysis end-stage renal disease were selected as the control group. The changes of cTnT and BNP echocardiographic abnormalities in the two groups were recorded, the mortality rate and clinical data of the two groups were compared, and the relationship between cTnT, BNP levels and prognosis in maintenance hemodialysis patients were analyzed. RESULTS The systolic blood pressure and serum creatinine urea nitrogen level in the observation group,were significantly higher than the control group, the difference was statistically significant(P<0.05). The incidence of abnormal echocardiographic detection in cTnT negative group(23.52%)was significantly lower than that in cTnT positive group(58.33%),the difference was statistically significant(P<0.05). The incidence of abnormal echocardiographic detection in BNP negative group(27.78%)was significantly lower than BNP positive group(60.87%), the difference was statistically significant(P<0.05). The mortality rate of cTnT negative group(11.76%)was significantly lower than that of cTnT positive group(41.67%), and the mortality rate of BNP negative group(16.67%)was significantly lower than BNP positive group(47.83%), the difference was statistically significant(P<0.05). The correlation analysis showed that cTnT and BNP levels were positively correlated with the prognosis. CONCLUSION The levels of cTnT and BNP were positively correlated with the prognosis of patients, the detection of these two indicators culd effectively improve the prognosis of patients with end-stage renal disease undergoing maintenance hemodialysis.reduce the mortality rate,whit was worthy of clinical evaluation for patient survival.