双多普勒同步取样技术测量Tei指数联合脑钠肽评价慢性肾病左心功能的研究
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摘要
目的探讨双多普勒同样取样技术测量Tei指数联合脑钠肽(BNP)评价慢性肾病左心功能的应用价值。方法选取我院2017年1～12月收治的80例慢性肾病患者(观察组)及40例健康体检的正常人(对照组)为研究对象,其中观察组分为早期肾功能不全组(早期组)、中晚期肾功能不全组(中晚期组)。比较观察组与对照组的常规超声检测指标、TDI检测指标,分析Tei指数与左室射血分数(LVEF)以及NT-proBNP的相关性。结果中晚期组的LVIDd、LVIDs、LA、IVSd、LVPWd均大于对照组,差异有统计学意义(P<0.05)。中晚期组的E、A、Tei指数、NTproBNP大于对照组,E/A、LVEF小于对照组,早期组E/A、LVEF小于对照组,Tei指数、NT-proBNP大于对照组,差异有统计学意义(P<0.05)。相关性分析显示,Tei指数与NT-proBNP呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论慢性肾病患者合并有一定的心功能损害,Tei指数与NT-proBNP可早期预测心功能损害的严重程度。
Objective To investigate the application value of Tei index detected by dual Doppler simultaneous sampling technique combined with brain natriuretic peptide in measuring left ventricular function in chronic kidney disease.Methods 80 patients with chronic kidney disease(observation group) and 40 healthy controls(control group) admitted in our hospital from January to December 2017 were selected as subjects. The observation group was divided into early renal dysfunction group(early group), mid-and end-stage renal dysfunction group(mid-and end-stage group). The conventional ultrasound detection index and TDI detection index of the observation group and the control group were compared, and the correlation between Tei index and left ventricular ejection fraction(LVEF) and NT-proBNP was analyzed.Results The LVIDd, LVIDs, LA, IVSd and LVPWd in the mid-and end-stage group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05). The E, A, Tei indexes and NT-proBNP of the mid-and end-stage group were higher than those of the control group, E/A and LVEF of the mid-and endstage group were lower than those of the control group. The E/A and LVEF of the early group were smaller than those of the control group, and the Tei index and NT-proBNP of the early group was larger than that of the control group.The difference was statistically significant(P<0.05). Correlation analysis showed that the Tei index was positively correlated with NT-proBNP(P<0.05) and negatively correlated with LVEF(P<0.05). Conclusion Patients with chronic kidney disease have a certain degree of cardiac dysfunction. Tei index and NT-proBNP can predict the severity of cardiac dysfunction early.
Objective To investigate the application value of Tei index detected by dual Doppler simultaneous sampling technique combined with brain natriuretic peptide in measuring left ventricular function in chronic kidney disease.Methods 80 patients with chronic kidney disease(observation group) and 40 healthy controls(control group) admitted in our hospital from January to December 2017 were selected as subjects. The observation group was divided into early renal dysfunction group(early group), mid-and end-stage renal dysfunction group(mid-and end-stage group). The conventional ultrasound detection index and TDI detection index of the observation group and the control group were compared, and the correlation between Tei index and left ventricular ejection fraction(LVEF) and NT-proBNP was analyzed.Results The LVIDd, LVIDs, LA, IVSd and LVPWd in the mid-and end-stage group were significantly higher than those of the control group, and the difference was statistically significant(P<0.05). The E, A, Tei indexes and NT-proBNP of the mid-and end-stage group were higher than those of the control group, E/A and LVEF of the mid-and endstage group were lower than those of the control group. The E/A and LVEF of the early group were smaller than those of the control group, and the Tei index and NT-proBNP of the early group was larger than that of the control group.The difference was statistically significant(P<0.05). Correlation analysis showed that the Tei index was positively correlated with NT-proBNP(P<0.05) and negatively correlated with LVEF(P<0.05). Conclusion Patients with chronic kidney disease have a certain degree of cardiac dysfunction. Tei index and NT-proBNP can predict the severity of cardiac dysfunction early.
引文
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[9]刘婧,张丽涓.血液透析患者心血管标志物水平变化与其预后的相关性研究[J].内科危急重症杂志,2017,23(5):410-412.
[10]姜挺,郑孝娥,张妍.Tei指数在冠心病患者随访中评价心功能的临床价值[J].医学与哲学,2016,37(8B):30-32.
[11]马云伶,杨雪莲,唐子勇,等.血液透析联合血液灌流对维持性血液透析患者左心室功能的保护作用[J].中国血液净化,2013,12(4):175-179.
[12]李静,梁燕玲,罗雪清,等.双多普勒同步取样技术测量Tei指数联合脑钠肽评价急性冠状动脉综合征左心功能的研究[J].中国循证心血管医学杂志,2017,9(5):606-608.
[13]黄雪霞,吴金玉,刘雪玲,等.300例慢性肾衰竭患者中医证型与左心结构及功能的相关性研究[J].中国中西医结合肾病杂志,2015,16(8):709-711.
[14]陈雪松,黄位,黄志清,等.应用超声心肌做功指数评价早期慢性肾衰患者左室功能[J].临床超声医学杂志,2014,16(12):841-842.
[15]Don-Wauchope AC,McKelvie RS.Evidence based application of BNP/NT-proBNP testing in heart failure[J]Clin Biochem,2015,48(4):236-246.
[2]唐玲,邓晓风,代青,等.高通量血液透析对尿毒症患者心肌损伤标志物和心功能指标的影响[J].中华危重病急救医学,2017,29(6):547-550.
[3]刘杰,陈爱华,于宠.Tei指数评价原发性高血压病患者左室舒张功能.临床超声医学杂志,2014,12(5):313-317.
[4]Levey AS,Atkins R,Coresh J,et al.Chronic kidney disease as a global public health problem:Approaches and initiatives-a position statement from kidney disease improving global outcomes[J].Kidney Int,2007,72(3):247-259.
[5]林丽容,黄明生,林石生.慢性肾病患者血肌酐含量检测及其与心功能损害的关系[J].海南医学院学报,2015,21(1):61-64.
[6]魏丽晶,詹婧,李蓥,等.血浆脑钠肽水平在慢性肾脏病患者心功能评价中的临床意义[J].中国老年学杂志,2016,36(17):4204-4206.
[7]胡绮雯,蔡琪,许敏玲,等.慢性肾功能衰竭维持性血透患者心功能变化临床观察[J].深圳中西医结合杂志,2015,25(16):7-9.
[8]吴岳春.每天短时透析在慢性肾病并难治性心力衰竭中的应用[J].医学临床研究,2016,33(9):1832-1833.
[9]刘婧,张丽涓.血液透析患者心血管标志物水平变化与其预后的相关性研究[J].内科危急重症杂志,2017,23(5):410-412.
[10]姜挺,郑孝娥,张妍.Tei指数在冠心病患者随访中评价心功能的临床价值[J].医学与哲学,2016,37(8B):30-32.
[11]马云伶,杨雪莲,唐子勇,等.血液透析联合血液灌流对维持性血液透析患者左心室功能的保护作用[J].中国血液净化,2013,12(4):175-179.
[12]李静,梁燕玲,罗雪清,等.双多普勒同步取样技术测量Tei指数联合脑钠肽评价急性冠状动脉综合征左心功能的研究[J].中国循证心血管医学杂志,2017,9(5):606-608.
[13]黄雪霞,吴金玉,刘雪玲,等.300例慢性肾衰竭患者中医证型与左心结构及功能的相关性研究[J].中国中西医结合肾病杂志,2015,16(8):709-711.
[14]陈雪松,黄位,黄志清,等.应用超声心肌做功指数评价早期慢性肾衰患者左室功能[J].临床超声医学杂志,2014,16(12):841-842.
[15]Don-Wauchope AC,McKelvie RS.Evidence based application of BNP/NT-proBNP testing in heart failure[J]Clin Biochem,2015,48(4):236-246.