肺部超声B线数量与腹膜透析患者水肿指数、NT-proBNP相关性及在容量超负荷中的评估效能
Correlation between the Number of Lung Ultrasound B-Lines and Edema Index,NT-proBNP in Patients Undergoing Peritoneal Dialysis and Its Eval-uation Efficacy in Volume Overload
吴楠 1吴超然 1陈曦 1陈玉华 1王雪芹 1石峰1
作者信息
- 1. 065000 河北 廊坊,河北中石油中心医院肾内科
- 折叠
摘要
目的 探讨肺部超声B线数量与腹膜透析患者水肿指数、N末端脑钠肽前体(NT-proBNP)相关性及在容量超负荷中评估效能.方法 按照1∶1 选取2022 年1 月—2023 年 8 月收治的 50 例尿毒症腹膜透析容量超负荷患者(超负荷组)、50 例尿毒症腹膜透析容量非超负荷患者(对照组)作为研究对象,采用肺部超声检测 2 组B线数量.以Pearson简单线性关系分析B线数量与水肿指数、NT-proBNP水平的相关性,比较2 组基线资料以及透析前后B线数量、水肿指数、NT-proBNP,偏相关性分析腹膜透析患者容量超负荷的相关影响因素,受试者工作特征曲线分析B线数量、水肿指数、NT-proBNP预测容量超负荷价值.结果 透析前后B线数量与水肿指数、NT-proBNP均呈显著正相关(P＜0.01);超负荷组血清白蛋白、尿素清除指数(Kt/V)低于对照组(P＜0.01).超负荷组透析前后B线数量、水肿指数、NT-proBNP均高于对照组,且 2 组透析后上述指标低于透析前(P＜0.05).校正了血清白蛋白、Kt/V后,B线数量、水肿指数、NT-proBNP 仍与腹膜透析患者容量超负荷呈正相关(P＜0.01).B 线数量、水肿指数、NT-proBNP预测腹膜透析患者容量超负荷的曲线下面积(AUC)分别为 0.784、0.709、0.810,而三者联合的 AUC为0.936,其预测敏感度为88.00%,特异度为90.00%(P＜0.01).结论 肺部超声检测B线数量与腹膜透析患者水肿指数、NT-proBNP密切相关,均与患者容量超负荷有关,三者联合检测可提高对腹膜透析患者容量超负荷的预测能力,可为容量管理提供客观参考信息和决策支持.
Abstract
Objective To investigate the correlation between the number of lung ultrasound B-lines and the edema in-dex,N-terminal pro-brain natriuretic peptide(NT-proBNP)in patients undergoing peritoneal dialysis,and to evaluate its effi-cacy in assessing volume overload.Methods A total of 50 patients with uremia undergoing peritoneal dialysis with volume overload(overload group)and 50 patients with uremia undergoing peritoneal dialysis without volume overload(control group)were selected at a ratio of 1∶1 from January 2022 to August 2023 as the research subjects.Lung ultrasound was used to detect the number of B-lines in both groups.Pearson simple linear correlation analysis was used to analyze the correlation of the num-ber of B-lines with the edema index and NT-proBNP levels.The baseline data of the two groups,as well as the number of B-lines,edema index,and NT-proBNP before and after dialysis,were compared.Partial correlation analysis was used to ana-lyze the relevant factors affecting volume overload in patients undergoing peritoneal dialysis.The receiver operating characteris-tic(ROC)curve was used to analyze the predictive value of the number of B-lines,edema index,and NT-proBNP for volume overload.Results Before and after dialysis,the number of B-lines was significantly and positively correlated with edema in-dex and NT-proBNP(P＜0.01).The serum albumin and dialyzer clearance of urea multiplied by dialysis time and normal-ized for urea distribution volume(Kt/V)in the overload group were lower than those in the control group(P＜0.01).The number of B-lines,edema index,and NT-proBNP in the overload group before and after dialysis were higher than those in the control group,and these indicators were lower after dialysis in both groups(P＜0.05).After adjusting for serum albumin and Kt/V,the number of B-lines,edema index,and NT-proBNP were still positively correlated with volume overload in patients undergoing peritoneal dialysis(P＜0.01).The area under the ROC curve of the number of B-lines,edema index,and NT-proBNP for predicting volume overload in patients undergoing peritoneal dialysis were 0.784,0.709,and 0.810,respectively,while the AUC of the combination of the three was 0.936,with a predictive sensitivity of 88.00%and specificity of 90.00%(P＜0.01).Conclusion The number of lung ultrasound B-lines is closely related to the edema index and NT-proBNP in patients undergoing peritoneal dialysis,and is associated with volume overload in patients.The combined de-tection of the three can improve the predictive ability of volume overload in patients undergoing peritoneal dialysis and provide objective reference information and decision support for volume management.
关键词
尿毒症/肺部超声/腹膜透析/水肿指数/N末端脑钠肽前体/容量超负荷/相关性/受试者工作特征曲线Key words
Uremia/Lung ultrasound/Peritoneal dialysis/Edema index/N-terminal pro-brain natriuretic peptide/Volume overload/Correlation/Receiver operating characteristic curve引用本文复制引用
基金项目
廊坊市科学技术研究与发展计划(2023013043)
出版年
2024
国家科技期刊平台
NSTL
万方数据