本文選題：腹膜透析　切入點：NT-proBNP　出處：《廣西醫(yī)科大學》2014年碩士論文

【摘要】：目的探討持續(xù)性不臥床腹膜透析（CAPD）患者的血清腦鈉肽前體（NT-proBNP）水平與患者容量狀態(tài)及心功能指標的關系，分析影響NT-proBNP的相關因素。 方法測定104例腹膜透析患者及30例健康對照組血清中的NT-proBNP值并相互比較，根據(jù)腹膜平衡試驗將CAPD患者分為不同腹膜轉運類型，分析不同轉運類型患者的NT-proBNP水平的差異，及其與其它容量負荷及心功能指標的相互關系，探討影響腹透患者血清NT-proBNP的相關因素，并評估其臨床意義。 結果CAPD患者的NT-proBNP水平與對照組相比明顯增高，差異有統(tǒng)計學意義；不同腹膜轉運類型腹透患者的NT-proBNP水平比較，組間差異有統(tǒng)計學意義，CAPD患者的NT-proBNP水平與其腹膜轉運類型呈正相關，高轉運類型的腹透患者NT-proBNP水平升高最明顯，，低轉運類型患者的NT-proBNP水平升高幅度相對最少（P0.05)。每日尿量＞100ml的CAPD患者血清NT-proBNP總體水平明顯低于每日尿量≤100ml患者，差異有統(tǒng)計學意義（F=5.744，P=0.018）；患者總Kt/V≥1.7患者的血清NT-proBNP總體水平低于總Kt/V＜1.7患者，差異無統(tǒng)計學意義（P＞0.05）；總Ccr≥50L/周患者的血清NT-proBNP總體水平低于總Ccr＜50L/周患者，差異無統(tǒng)計學意義（P＞0.05）。NT-proBNP水平與水腫、收縮壓升高、攝入量、血肌酐、心胸比例、心影增大、LVEDD、LVESD、LVST及LAD呈正相關，與年齡段、殘腎KT/V、殘腎Ccr、Hb、Alb、Ca及LVEF呈負相關。 結論CAPD患者的NT-proBNP水平普遍升高，且在不同腹膜轉運類型組及不同尿量組之間存在差異，并與血容量負荷評估的有效指標密切相關，與殘余腎功能、貧血及營養(yǎng)狀態(tài)也存在一定的相關性。
[Abstract]:Objective to investigate the relationship between the serum NT-proBNPs and the volume status and cardiac function in patients with continuous ambulatory peritoneal dialysis (PD) and to analyze the related factors affecting NT-proBNP. Methods Serum NT-proBNP levels in 104 patients with peritoneal dialysis and 30 healthy controls were measured and compared. According to peritoneal balance test, CAPD patients were divided into different types of peritoneal transport, and the difference of NT-proBNP levels in patients with different transport types was analyzed. To explore the related factors of serum NT-proBNP in patients with peritoneal dialysis and its relationship with other indexes of volume load and cardiac function, and to evaluate its clinical significance. Results the level of NT-proBNP in CAPD patients was significantly higher than that in the control group, and the NT-proBNP level in patients with different peritoneal transport types was significantly higher than that in the control group. There was a positive correlation between the NT-proBNP level and the peritoneal transport type in CAPD patients. The NT-proBNP level in patients with high transport type was significantly higher than that in patients with high transport type. The level of NT-proBNP in patients with low transport type was significantly lower than that in patients with daily urine volume 鈮

本文編號：1691604