Objective:To investigate the serum level of amino-terminal pro-B-natriuretic peptide (NT-proBNP) and its relationship with cardiovascular disease (CVD) and malnutrition in maintenance hemodialysis ( MHD) patients. Methodology: Blood samples were obtained from one hundred thirty MHD patients before undergoing hemodialysis. The serum NT-proBNP was measured by electro-chemoluminiscence immunoassay. Spearman correlation and linear regression were used to assess the correlation between NT-proBNP and other parameters. Receiver operating characteristic (ROC) curves were used to assess the relationship with NT-proBNP, cardiac troponin T(cTnT) , high-sensitive C reactive protein (hsCRP) and left ventricular hypertrophy. Results;The levels of serum NT-proBNP were significantly higher in MHD patients, the patients with CVD had more higher serum NT-proBNP levels than that those without CVD (4 649 [2 920-14 069]pg/ml vs 3006 [ 1 457 -7 478]pg/ml,P = 0. 002). In all MHD patients,serum NT-proBNP was correlated positively with age ( ρ = 0. 195, P = 0. 026) , systolic blood pressure ( ρ = 0. 306, P = 0. 001 ) , hsCRP ( p = 0. 228, P =0. 009) ,cTnT ( ρ = 0. 448, P < 0. 001 ) , carotid artery intima-media thickness ( ρ = 0. 244, P = 0. 021 ) and leftrnventricular mass index ( ρ = 0. 537 , P < 0. 001) ; while negatively with body mass index ( ρ = - 0. 153 , P = 0. 031 ) , pre-albumin (ρ = -0. 304 ,P <0. 001) , triglyceride ( ρ = - 0. 246,P = 0. 014) , total cholesterol ( ρ = - 0. 265,P = 0. 008) , low density lipoprotein cholesterol( ρ = -0. 254, P =0.012) and left ventricular ejection fraction(ρ= -0. 194,P =0.040). Linear regression analysis showed that cTnT ((3=0. 463 ,P =0. 001) ,left ventricular mass index ( β =0. 324,P =0. 003) and systolic blood pressure ( (3 = 0. 208, P =0. 008) were independently associated with NT-proBNP. ROC curves analysis showed that the relationship between NT-proBNP and left ventricular hypertrophy was more closely than that cTnT and hsCRP. Conclusion; Serum NT-proBNP is markedly elevated in MHD patients, which is associated with CVD and malnutrition.%目的:观察维持性血液透析(MHD)患者血清氨基末端脑钠肽(NT-proBNP)水平及其与心血管疾病和营养不良的关系. 方法:选取治疗3月以上的MHD患者,采用电化学发光法检测受试者血清NT-proBNP.用Spearman相关和线性回归分析NT-proBNP与其他指标之间的相关性.用受试者工作特征(ROC)曲线比较NT-proBNP、肌钙蛋白T(cTnT)及高敏C反应蛋白(hsCRP)与左心室肥大的相关性. 结果:130例MHD患者血清NT-proBNP水平皆显著高于正常参考值.合并心血管疾病(CVD)的患者血清NT-proBNP水平显著高于非CVD患者[4 649(2 920 ～ 14 069) pg/ml vs3 006(1 457～7 478) pg/ml,P=0.002].Spearman相关分析显示血清NT-proBNP与年龄(ρ =0.195,P=0.026)、收缩压(ρ =0.306,P=0.001)、hsCRP(ρ=0.228,P=0.009)、cTnT(ρ=0.448,P＜0.001)、颈动脉内膜中层厚度(ρ =0.244,P=0.021)及左心室质量指数(ρ =0.537,P＜0.001)呈正相关,与体质量指数(ρ=-0.153,P=0.031)、血清前白蛋白(ρ=-0.304,P＜0.001)、三酰甘油(ρ=-0.246,P=0.014)、总胆固醇(ρ=-0.265,P=0.008)、低密度脂蛋白胆固醇(ρ=-0.254,P=0.012)及左心室射血分数(ρ=-0.194,P =0.040)呈负相关.线性回归分析显示cTnT(β =0.463,P=0.001)、左心室质量指数(β=0.324,P =0.003)及收缩压(β=0.208,P=0.008)与血清NT-proBNP水平独立相关.ROC曲线分析显示NT-proBNP水平与左心室肥大的相关性高于cTnT及hsCRP. 结论:MHD患者血清NT-proBNP水平显著升高,NT-proBNP水平与患者伴发CVD及营养不良相关.
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