CAPD患者血清N-末端脑钠素与干体重及左心室结构功能的关系

目的研究血清N-末端脑钠素（NT-PRO-BNP）与持续性非卧床腹膜透析（CAPD）患者左心室结构功能及干体重的关系。方法选取本院腹膜透析中心随访稳定的CAPD患者24例为CAPD组,另外将来自体检中心年龄、性别相匹配的健康志愿者20名作为正常对照组,采用免疫荧光测定法检测两组对象NT-PRO-BNP浓度。根据NT-PRO-BNP浓度将CAPD组患者分为3个等级,比较各等级患者年龄、性别、糖尿病（diabetes mellitus,DM）数、体重指数、总kt/V;并根据Penn公式采用彩色多普勒测算CAPD患者左心室心肌重量指数（LVMI）、左心室舒张末内径（LVEDD）和左心室射血分数（LVEF）;同时计算下腔静脉直径（IVCD）与体表面积（BSA）的比值（VCD）,用以评估CAPD患者干体重。结果 CAPD组患者NT-PRO-BNP水平明显高于对照组;Ⅲ级患者的LVMI最高,LVEF最低,VCD最高;逐步回归分析结果显示,CAPD患者NT-PRO-BNP水平与LVMI、VCD呈正相关,与LVEF呈负相关,LVEF（β=-0.775,P=0.018）、LVMI（β=0.592,P=0.031）与VCD（β=0.645,P=0.009）均与NT-PRO-BNP独立相关。结论血清NT-PRO-BNP水平可能是有用的评估CAPD患者左心室功能和干体重的临床标志物。

The relationship between serum NT-PRO-BNP and body weight,left ventricular structure and function in CAPD patients

Objective To study the relationship between serum N-terminal brain natriuretic peptides （NT-PRO-BNP）,body weight,left ventricular structure and function in continuous ambulatory peritoneal dialysis （COPD） patients.Methods This clinical study included 24 stable CAPD patients followed up by our peritoneal dialysis center （experimental group） and 20 healthy volunteer with comparable age and gender from medical examination center （control group）.Concentration of serum NT-PRO-BNP was measured by immunofluorescence method.The patients were divided into 3 grades based on the concentration of NT-PRO-BNP.The age,gender,number of patients with diabetes mellitus （DM）,body index and total Kt/V were compared.Left ventricular mass index （LVMI）,left ventricular end-diastolic diameter （LVEDD） and ejection fraction （LVEF） were measured by color Doppler and the results were calculated by Penn formula.Body weight was calculated based on the ratio of diameter of inferior vena cava to body surface area.Results Compared to the control group,the level of serum NT-PRO-BNP of CAPD patients was remarkably increased.Grade III patients in the had the highest value of LVMI and VCD,and a lowest value of LVEF.Stepwise regression analysis revealed that,in CAPD patients,level of NT-PRO-BNP was positively correlated with LVMI and VCD,and negatively correlated to LVEF.LVEF （β =-0.775,P =0.018）,LVMI （β =0.592,P =0.031） and VCD （β =0.645,P =0.009） were all independently related to NT-PRO-BNP.Conclusion The lever of serum NT-PRO-BNP may be used as a clinic marker to assess the left ventricular function and body weight in CAPD patients.