摘要
目的观察合并不同心血管疾病肾功能不全(RI)患者肾小球滤过率(GFR)、N末端脑钠肽前体(NT-proBNP)与超敏肌钙蛋白T(hs-TnT)的变化。方法选择2019年8月—2020年2月在南方医科大学附属小榄医院确诊的160例RI患者作为研究对象;按合并疾病不同分为单纯RI组(16例)、RI合并高血压组(48例)、RI合并高血压与冠心病/心肌梗死(心梗)组(68例)、RI合并高血压、冠心病/心梗及心力衰竭(心衰)组(28例);另选择同期健康体检者30例作为健康对照组。测定各组血清肌酐(SCr)、NT-proBNP、hs-TnT水平,并通过肾脏病膳食改良试验(MDRD)简化方程计算GFR,比较合并不同心血管疾病RI患者GFR、NT-proBNP与hs-TnT的差异。结果不同性别RI患者SCr、GFR、NT-proBNP、hs-TnT水平比较差异均无统计学意义(均P>0.05);合并不同心血管疾病各组RI患者的SCr、NT-proBNP、hs-TnT水平均明显高于健康对照组,GFR明显低于健康对照组,且合并高血压、冠心病/心梗及心衰组与健康对照组差异最显著〔SCr(μmol/L):669.0(245.0,900.0)比73.0(57.2,83.5),NT-proBNP(ng/L):23709.0(2788.0,35000.0)比85.0(42.5,174.0),hs-TnT(μg/L):72.0(43.0,182.0)比8.0(5.0,11.2),GFR(mL·min^-1·1.73 m^-2):8.0(4.0,25.0)比99.0(74.2,108.7),均P<0.01〕;随合并疾病增多,RI患者的SCr、NT-proBNP、hs-TnT水平呈逐渐上升趋势,GFR呈逐渐下降趋势,差异均有统计学意义(均P<0.01)。结论NT-proBNP、hs-TnT水平与RI患者并发心血管疾病有关,临床医师需早期诊断并给予治疗,以减少并发症数量,改善患者预后。
Objective To observe the changes of glomerular filtration rate(GFR),N-terminal pro-brain natriuretic peptide(NT-proBNP)and hypersensitive troponin T(hs-TnT)in the patients with renal insufficiency(RI)complicated with different cardiovascular diseases.Methods The 160 patients with RI diagnosed in Xiaolan Hospital Affiliated to Southern Medical University from August 2019 to February 2020 were selected as the research objects.According to the different complications,the patients were divided into simple RI group(16 cases),RI combined with hypertension group(48 cases),RI combined with hypertension and coronary heart disease/myocardial infarction(MI)group(68 cases),RI combined with hypertension,coronary heart disease/MI and heart failure(HF)group(28 cases);other 30 healthy people were selected as the healthy control group.The levels of serum creatinine(SCr),NT-proBNP and hs-TnT of all patients were detected and GFR was calculated using modification of diet in renal disease(MDRD).The changes of GFR,NT-proBNP and hs-TnT levels in RI patients complicated with different cardiovascular diseases were compared.Results There were no significant differences in SCr,GFR,NT-proBNP and hs-TnT levels between different genders(all P>0.05).The levels of SCr,NT-proBNP and hs-TnT in RI patients with different cardiovascular diseases were significantly higher than those in healthy control group,GFR was significantly lower than that in healthy control group,and differences between the group with hypertension,coronary heart disease/MI and HF and heathy control group was the most significant[SCr(μmol/L):669.0(245.0,900.0)vs.73.0(57.2,83.5),NT-proBNP(ng/L):23709.0(2788.0,35000.0)vs.85.0(42.5,174.0),hs-TnT(μg/L):72.0(43.0,182.0)vs.8.0(5.0,11.2),GFR(mL·min-1·1.73 m-2):8.0(4.0,25.0)vs.99.0(74.2,108.7),all P<0.01].With the increase of comorbidities,the levels of SCr,NT-proBNP and hs-TnT increased gradually,and GFR decreased gradually,with significant differences(all P<0.01).Conclusion The levels of NT-proBNP and hs-TnT were correlated with complicated cardiovascular disease in RI patients,early diagnosis and treatment should be carried out by clinicans to reduce the number of complications and improve the prognosis of patients.
作者
张杰良
黄雪珍
邓文成
邱智枫
Zhang Jieliang;Huang Xuezhen;Deng Wencheng;Qiu Zhifeng(Clinical Laboratory,Xiaolan Hospital Affiliated to Southern Medical University,Zhongshan 528415,Guangdong,China)
出处
《实用检验医师杂志》
2020年第3期143-146,共4页
Chinese Journal of Clinical Pathologist
关键词
肾功能不全
心血管疾病
N末端脑钠肽前体
超敏肌钙蛋白T
Renal insufficiency
Cardiovascular disease
N-terminal pro-brain natriuretic peptide
Hypersensitive troponin T
