首页|氨基末端-B型利钠肽前体与超敏C反应蛋白在预测免疫球蛋白A肾病并发心功能不全中的临床意义

氨基末端-B型利钠肽前体与超敏C反应蛋白在预测免疫球蛋白A肾病并发心功能不全中的临床意义

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目的 探索氨基末端-B型利钠肽前体(NT-proBNP)与超敏C反应蛋白(hs-CRP)在预测免疫球蛋白A肾病(IgAN)并发心功能不全中的临床意义。方法 选取2022年1月至12月于九江市中医医院就诊IgAN患者60例作为研究对象,并选取同期正常体检者60例作为对照组。通过对患者进行肌酐测定,计算IgAN患者的肾小球滤过率(GFR),评估患者的IgAN相关慢性肾脏疾病(CKD)分期,并对所有患者进行心脏彩超检查,通过左室射血分数(LVEF)以及临床表现确定心功能不全等级,按照心功能不全等级将其分为A组(n=20)、B组(n=17)、C组(n=13)和D组(n=10),检测并比较五组的血清NT-proBNP、hs-CRP水平差异,采用Spearman相关性分析NT-proBNP、hs-CRP与CKD分期、LVEF、心功能不全等级的关系。结果 四组的GFR水平比较,D组<C组<B组<A组,差异有统计学意义(P<0。05);四组的CKD分期比较,C、D组的分期高于A、B组,差异有统计学意义(P<0。05);五组的LVEF水平比较,D组<C组<B组<A组<对照组,差异有统计学意义(P<0。05);五组的NT-proBNP与hs-CRP水平比较,D组>C组>B组>A组>对照组,差异有统计学意义(P<0。05);Spearman 相关性分析显示,IgAN患者血清NT-proBNP、hs-CRP与CKD分期、心功能不全等级呈显著正相关,与LVEF呈显著负相关(P<0。05)。结论 NT-proBNP和hs-CRP均可作为IgAN并发心功能不全的患者的预测指标,且NT-proBNP和hs-CRP可反映CKD分期及心功能不全等级,早期检测分析对初步诊断与治疗方针制定有重要的临床意义。
Clinical significance of N-terminal pro-B-type natriuretic peptide and hypersensitive C-reactive protein in predicting immunoglobulin A nephropathy with cardiac insufficiency
Objective To explore the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP)and hypersensitive C-reactive protein(hs-CRP)in the predicting of immunoglobulin A nephropathy(IgAN)with cardiac insufficiency.Methods A total of 60 patients with IgAN admitted to Jiujiang Traditional Chinese Medicine Hospital from January to December 2022 were selected as the study subjects,and 60 normal examinees during the same period were selected as the control group.By measuring creatinine levels in patients,glomerular filtration rate(GFR)in IgAN patients was calcuiated,the staging of IgAN related chronic kidney disease(CKD)in patients was evaluated,and cardiac ultrasound examinations on all patients was conducted,the level of cardiac dysfunction was determined based on left ventricular ejection fraction(LVEF)and clinical manifestations.According to the level of cardiac dysfunction,patients were divided into group A(n=20),group B(n=17),group C(n=13),and group D(n=10),the differences in serum NT-proBNP and hs-CRP levels among five groups were detected and compared,and Spearman correlation analysis was used to examine the relation-ship between NT-proBNP,hs-CRP,CKD stage,LVEF,and level of cardiac dysfunction.Results The GFR levels among four groups was compared,the difference was statistically significant(P<0.05)between group D<group C<group B<group A;the CKD staging of the four groups was compared,and the staging of groups C and D was higher than that of groups A and B,the differences were statistically significant(P<0.05);the LVEF levels of 5 groups were compared,the difference were statistically significant(P<0.05)between group D<group C<group B<group A<control group;The levels of NT-proBNP and hs CRP in 5 groups were compared,with group D>group C>group B>group A>control group,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the serum NT-proBNP and hs-CRP levels in IgAN patients were significantly positively correlated with CKD stage and heart failure grade,and significantly negatively correlated with LVEF(P<0.05).Conclusion NT-proBNP and hs-CRP can both serve as predictive indicators for patients with IgAN complicated with heart failure,and NT-proBNP and hs-CRP can reflect CKD staging and level of heart failure.Early detection and analysis have important clinical significance for preliminary diagnosis and treatment policy formulation.

N-terminal pro-B-type natriuretic peptideHypersensitive C-reactive proteinCardiac insufficiencyIm-munoglobulin A nephropathy

代建风、李丽、侯进、余丽

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江西省九江市中医医院肾病研究室,江西九江 332000

氨基末端-B型利钠肽前体 超敏C反应蛋白 心功能不全 免疫球蛋白A肾病

江西省卫生健康委科技项目

202211962

2024

中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
年,卷(期):2024.31(1)
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