贵州医科大学学报

2020, v.45;No.234(03) 363-367

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血清Cys-C和NT-proBNP对维持性血液透析患者心血管事件发生的影响
Effects of Serum Cys-C and NT-proBNP on Cardiovascular Events in Maintenance Hemodialysis Patients

牛世慧;刘莉;王珣;
NIU Shihui;LIU Li;WANG Xun;Department of Nephrology,the Second People's Hospital of Hefei City;

摘要(Abstract):

目的:探讨血清胱抑素C(Cys-C)、氨基末端脑利钠肽前体(NT-proBNP)对维持性血液透析患者心血管事件发生的影响。方法:64例维持性血液透析患者分为心血管事件组(n=25例)与无心血管事件组(n=39),检测2组患者入院时血清Cys-C及NT-proBNP水平,比较2组患者入院时的临床资料[性别、年龄、原发疾病、透析时间、左心室射血分数(LVEF)、左室舒张末内径(LVDD)、左室收缩末内径(LVDS)、室间隔厚度(IVST)及左室厚壁厚度(LVPWT)及血清胆固醇(TC)、肌酐(Scr)、尿酸(UA)、血钙、血磷、钙磷乘积、白蛋白(Alb)、血尿素氮(BUN)、高密度脂蛋白(HDL)、全段甲状旁腺素(i PTH)、低密度脂蛋白(LDL)、总蛋白(TP)、三酰甘油(TG)水平],采用Logistic多元回归分析有差异指标中导致心血管事件的独立危险因素,采用Person相关性分析血清Cys-C、NT-proBNP水平与这些危险因素的相关性。结果:心血管事件组患者的年龄、血钙、血液透析时间、心率、i PTH、UA、Cys-C及NT-proBNP水平明显高于非心血管事件组(P <0. 05); Logistic多因素分析结果显示,i PTH(OR=0. 795,95%CI为0. 657~0. 946)、UA(OR=0. 619,95%CI为0. 574~0. 753)、Cys-C(OR=2. 660,95%CI为1. 108~4. 289)及NT-proBNP(OR=7. 734,95%CI为1. 435~18. 667)是导致心血管事件发生的独立危险因素(P <0. 05); Person相关分析结果显示,患者血清Cys-C与i PTH(r=0. 336)及UA(r=0. 625)水平呈正相关(P<0. 05),患者血清NT-proBNP与UA水平呈正相关(r=0. 364,P <0. 05)。结论:在维持性血液透析期间监测患者血清Cys-C与NT-proBNP水平可预防心血管事件的发生。
Objective: To investigate the effects of serum cystatin C( Cys-C) and amino-terminal brain natriuretic peptide precursor( NT-proBNP) on cardiovascular events in patients with maintenance hemodialysis. Methods: A total of 64 patients with maintenance hemodialysis were selected and divided into cardiovascular event group( 25 cases) and non-cardiovascular event group( 39 cases)according to the presence or absence of cardiovascular events. The serum Cys-C,NT-proBNP levels and basic conditions were examined in both groups of patients. Cardiovascular event-related indicators of the two groups at admission were compared. Logistic multivariate regression was used to analyze the independent risk factors leading to cardiovascular events in the difference indicators and the correlation between serum Cys-c and NT-proBNP levels and these risk factors was analyzed by using Person correlation. Results: The age,blood calcium,hemodialysis time,i PTH,heart rate,UA,Cys-C,and NT-proBNP in the cardiovascular event group were higher than those in the non-cardiovascular event group,and the differences were statistically significant( P < 0. 05). Multivariate analysis results showed that i PTH, UA, Cys-C, and NT-proBNP were independent risk factors leading to cardiovascular events( P < 0. 05); the correlation analysis showed that serum ys-c was positively correlated with serum i PTH( r = 0. 336,P < 0. 05) and UA( r = 0. 625,P < 0. 05); serum nt-probnp was positively correlated with serum UA( r = 0. 015,P < 0. 05). Conclusion: The detection of serum Cys-C and NT-proBNP levels during maintenance hemodialysis has certain guiding significance for predicting the occurrence of cardiovascular events.

关键词(KeyWords): 危险因素;血清胱抑素C;氨基末端脑利钠肽前体;维持性血液透析;心血管事件;终末期肾脏疾病
risk factors;serum cystatin C;amino-terminal brain natriuretic peptide precursor;maintenance hemodialysis;cardiovascular events;end-stage renal disease

Abstract:

Keywords:

基金项目(Foundation): 合肥市第二人民医院项目[(2017)47]

作者(Author): 牛世慧;刘莉;王珣;
NIU Shihui;LIU Li;WANG Xun;Department of Nephrology,the Second People's Hospital of Hefei City;

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DOI: 10.19367/j.cnki.1000-2707.2020.03.022

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