李 昊, 殷艳蓉, 田 刚. 连续静脉血液滤过治疗对血浆NT-proBNP水平的影响及其意义[J]. 心脏杂志, 2012, 24(4): 498-502.
    引用本文: 李 昊, 殷艳蓉, 田 刚. 连续静脉血液滤过治疗对血浆NT-proBNP水平的影响及其意义[J]. 心脏杂志, 2012, 24(4): 498-502.
    Changes and significance of plasma NT-proBNP level in patients treated with continuous veno-venous hemofiltration[J]. Chinese Heart Journal, 2012, 24(4): 498-502.
    Citation: Changes and significance of plasma NT-proBNP level in patients treated with continuous veno-venous hemofiltration[J]. Chinese Heart Journal, 2012, 24(4): 498-502.

    连续静脉血液滤过治疗对血浆NT-proBNP水平的影响及其意义

    Changes and significance of plasma NT-proBNP level in patients treated with continuous veno-venous hemofiltration

    • 摘要: 目的:研究连续静脉血液滤过(CVVH)对N端脑钠尿肽原(NT-proBNP)的影响,以及此类患者CVVH治疗前后NT-proBNP的水平和心功能的相关性。方法: 对50例接受CVVH治疗患者的临床资料进行回顾性分析,收集CVVH治疗前后的血样,采用电化学发光免疫技术检测血浆NT-proBNP的水平,并比较NT-proBNP水平在血液净化治疗前后的变化及其与左室射血分数(LVEF)的相关性。结果: 血浆NT-proBNP的水平在CVVH治疗前明显高于治疗后(P<0.01)。CVVH治疗前NT-proBNP的水平与LVEF呈负相关性(Pearson系数为-0.783),治疗结束后此种相关性消失。CVVH治疗前,死亡组患者NT-proBNP的水平高于存活组患者(P<0.01)。治疗结束后,两组患者血浆NT-proBNP的水平无统计学差异。结论: CVVH治疗可以使血浆NT-proBNP的水平显著下降,且NT-proBNP水平下降的程度与CVVH治疗的时间及脱水量呈正相关。对于接受CVVH治疗及肾功能不全的患者,需慎重以NT-proBNP的水平作为评价心功能的血清学指标。

       

      Abstract: AIM:To explore the influence and significance of serum NT-proBNP level in patients treated with continuous veno-venous hemofiltration (CVVH) and to investigate the relationship of NT-proBNP and heart function before and after CVVH therapy. METHODS: Clinical data of 50 patients treated with CVVH therapy were retrospectively analyzed. The level of NT-proBNP was measured by electrochemiluminescence immunoassay and the changes of NT-proBNP with LVEF were compared before and after CVVH therapy. RESULTS: The NT-proBNP level before CVVH therapy was significant higher than that after CVVH therapy (P<0.01). Before CVVH therapy, NT-proBNP was closely related to LVEF (Pearson correlation is -0.783), whereas after CVVH the correlation of NT-proBNP and LVEF disappeared. Before CVVH therapy, the NT-proBNP level of nonsurvivors was higher than that of survivors, whereas after CVVH no statistically difference was observed between nonsurvivors and survivors. CONCLUSION: CVVH therapy significantly decreases plasma NT-proBNP level and the descent is closely related to the amount of dehydration and time of CVVH therapy. As a biochemical marker to evaluate the heart function of patient, NT-proBNP should be cautiously used in patients with renal insufficiency and patients treated with CVVH.

       

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