NT—proBNP和CysC在慢性心肾综合征早期诊断和预后评价中的研究


  [摘要] 目的 在慢性心肾综合征(CRS)早期诊断中检测N末端B型氨基端利钠肽原(NT-proBNP)和胱抑素C(CysC)及对患者预后效果的评价价值。方法 随机抽取该院2016年5月—2017年5月收治的200例性心力衰竭(CHF)患者展开研究,将其中肾小球滤过率(GFR)低于60 mL/min的100例作为A组;其余GFR超过60 mL/min的100例作为B组,对比两组NT-proBNP、CysC、血清肌酐(Scr)检测结果。结果 ①A组NT-proBNP水平、CysC水平、Scr水平依次是(2.39±0.68)μg/L、(1.75±0.60)mg/L、(388.65±63.23)μmol/L,显著高于B组的(0.82±0.12)μg/L、(0.98±0.34)mg/L、(76.22±10.31)μmol/L,比较差异有统计学意义(P<0.05)。②A组II级患者的NT-proBNP、CysC、Scr水平低于III级(P<0.05),III级低于IV级(P<0.05)。I期慢性CRS患者的NT-proBNP水平、CysC水平、Scr水平低于II期(P<0.05);II期低于III期;III期低于IV期(P<0.05)。结论 检测慢性CRS患者的NT-proBNP、CysC可以明确其病程程度,同时又能对预后效果给予有效评估。
  [关键词] 慢性心肾综合;NT-proBNP;CysC;早期诊断;预后评价
  [中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2018)01(c)-0009-03
  [Abstract] Objective This paper tries to evaluate the value of N-terminal pro-N-terminal pro-brain natriuretic peptide (NT-proBNP) and cystatin C (CysC) in the early diagnosis of chronic heart-kidney syndrome (CRS) and to evaluate their prognostic value. Methods A total of 200 patients with congestive heart failure (CHF) admitted to this hospital from May 2016 to May 2017 were random selected in this study. 100 patients with glomerular filtration rate (GFR) less than 60 mL/min were selected as group A; The remaining 100 cases of GFR exceeded 60 mL/min as group B, and compared the results of NT-pro BNP, CysC and serum creatinine(Scr). Results ①The levels of NT-proBNP, CysC and Scr in group A were (2.39±0.68)μg/L,(1.75±0.60)mg/L and(388.65±63.23)μmol/L, significantly higher than that of group B of respectively (0.82±0.12)μg/L, (0.98±0.34)mg/L, (76.22±10.31)μmol/L, with significant difference(P<0.05). ②NT-proBNP, CysC and Scr in group A patients with grade II were lower than grade III(P<0.05), grade III was lower than grade IV(P<0.05). The level of NT-proBNP, CysC and Scr in stage I patients with chronic CRS were lower than those in stage II(P<0.05); stage II was lower than stage III; stage III was lower than stage IV(P<0.05). Conclusion The detection of NT-proBNP and CysC in patients with chronic CRS can confirm the course of the disease and at the same time can effectively evaluate the prognosis.
  [Key words] Chronic heart-kidney syndrome; NT-proBNP; CysC; Early diagnosis; Prognosis evaluation
  要想對慢性CRS患者提供有效的治疗方法,首先就要加强其早期诊断,提高诊断结果的准确性,明确患者的病情程度,为临床治疗提供参考。随着慢性CRS的患病率逐年增加,在其早期诊断中联合检测NT-proBNP、CysC已经不断受到临床医务人员的重视,前者属于心功能受损标志物,后者是反映患者肾损害、GFR变化的一项重要指标[1]。为了进一步分析这两个指标对慢性CRS早期诊断效果,以及对其预后效果的评估价值,该次研究随机抽取了2016年5月—2017年5月该院收治的200例对象进行详细的分析,并将具体的研究情况与结果报道如下。
  1 资料与方法