慢性肾脏病血清β-脑钠肽、同型半胱氨酸与心血管病变的关系

目的探讨血清β-钠肽（BNP）、同型半胱氨酸（Hcy）与慢性肾脏病（CKD）35期心血管事件的发生和病死率的关系。方法本组77例CKD患者，按NKF-DOQI指南分为CKD3期（A组）17例，CKD4期（B组）21例和CKD5期（C组）39例。正常对照组30例，观察各组临床表现、生化指标，血清BNP、Hcy等变化。同时，将77例患者根据Hcy数值分为升高组和正常组，观察其与心血管疾病（CVD）的相关性。结果与正常对照组比较，A、B、C组血肌酐（SCr）、尿素氮（BUN）、BNP明显升高，B组与A组比较，C组与B组比较，各组数值差异均有统计学意义。与Hcy正常组比较，Hcy升高组发生CVD明显增加，具有正相关关系。结论本研究显示，BNP和Hcy可作为慢性肾衰竭早期心血管损害的指标之一，BNP，Hcy与CVD发生及病死率的关系密切，BNP、Hcy越高，CVD的发生率越高，病死率也越高。

The plasma brain natriuretic peptide and homocysteine is relating to the occurrence of the cardiovascular events and the mortality in the stage 3-5 chronic kidney disease

Objective To investigate the of relationship plasma brain natriuretic peptide （BNP） and Homocysteine （Hcy） with the cardiovascular disease （CVD） and the mortality in the chronic kid- ney disease. Methods Ninety-two patients with chronic kidney disease were divided into 3 groups according to K/DOQI： 17 patients in stage 3 CKD （group A）, 21 patients in stage 4 CKD （group B）, and 39 patients in stage 5 CKD （group C）. Observe the clinical manifestations, biochemical parameters, changes such as serum BNP.Hcy, etc in each group. Meanwhile, 92 patients were divided into the two groups according to Hcy, and study the relationship between Hcy and CVD. Results The level of BNP were significant higher in the groups A.B.C than those control group , and BNP levels were positive correlatived with the worsen of renal function. The groups with higher levels of Hcy had significant higher incidence of CVD than the normal group, and relationship was positive. Conclusions The BNP and Hey could be used as one of an early cardiovascular damage parameter in chronic renal insufficient. This research shows that the BNP,Hcy in patients with chronic kidney disease are closely related to the cardiovascular morbility and mortality. The higher the BNP and Hey level , the higher the incidents of cardiovascular events and corresponding mortality.