林秀玉 戴云 楊斌
[摘要] 目的 探討血液透析(HD)患者肌鈣蛋白T(cTnT)、N-末端腦鈉肽(NT-proBNP)與心臟超聲聯(lián)合檢查的臨床意義。方法 隨機(jī)選擇該院2017年1月—2019年1月收治的HD患者70例進(jìn)行研究,均進(jìn)行1年以上隨訪,根據(jù)隨訪期間有無(wú)心血管事件分為兩組,其中有心血管事件為觀察組(n=28例)、無(wú)心血管事件為對(duì)照組(n=42例)。兩組對(duì)象均有完整資料,完成血清cTnT與NT-proBNP檢測(cè)及心臟超聲檢查。比較兩組血清cTnT與NT-proBNP及心臟超聲指標(biāo)。結(jié)果 觀察組血清cTnT與NT-proBNP分別為(0.332±0.066)、(304.33±54.37)ng/mL;對(duì)照組血清cTnT與NT-proBNP分別為(0.184±0.052)、(264.73±43.94)ng/mL;對(duì)比兩組cTnT(t=4.207,P<0.05);對(duì)比兩組NT-proBNP(t=5.886,P<0.05)。觀察組LAD(36.95±2.15)mm、LVDd(52.83±4.62)mm、IVST(13.84±2.55)mm、LVEF(52.49±7.56)%;對(duì)照組LAD(35.63±2.06)mm、LVDd(48.43±5.03)mm、IVST(10.94±2.13)mm、LVEF(56.84±8.05)%;對(duì)比兩組LAD(t=2.592,P<0.05);對(duì)比兩組LVDd(t=2.883,P<0.05);對(duì)比兩組IVST(t=2.904,P<0.05);對(duì)比兩組LVEF(t=3.206,P<0.05)。結(jié)論 HD患者應(yīng)用血清cTnT與NT-proBNP檢測(cè)聯(lián)合心臟超聲檢查,可盡早明確有無(wú)心血管事件風(fēng)險(xiǎn),根據(jù)檢測(cè)結(jié)果及時(shí)評(píng)估,積極干預(yù),可避免或減少心血管事件發(fā)生。
[關(guān)鍵詞] 血液透析;肌鈣蛋白T;N-末端腦鈉肽;心臟超聲;心血管事件
[中圖分類號(hào)] R5? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742(2020)09(b)-0189-03
Study on the Clinical Significance of Troponin T and N-terminal Brain Natriuretic Peptide Combined with Cardiac Ultrasound in Hemodialysis Patients
LIN Xiu-yu, DAI Yun, YANG Bin
Department of Ultrasound Diagnosis, Eastern Theater General Hospital of the Chinese People's Liberation Army, Nanjing, Jiangsu Province, 210000 China
[Abstract] Objective To explore the clinical significance of combined examination of troponin T (cTnT), N-terminal brain natriuretic peptide (NT-proBNP) and cardiac ultrasound in hemodialysis (HD) patients. Methods Seventy HD patients admitted to our hospital from January 2017 to January 2019 were randomly selected for the study. All were followed up for more than 1 year. According to whether there were cardiovascular events during the follow-up period, they were divided into two groups, of which cardiovascular events were the observation group (n=28 cases) and no cardiovascular events were used as the control group (n=42 cases). Both groups of subjects have complete data, complete the detection of serum cTnT and NT-proBNP and cardiac ultrasound. The serum cTnT and NT-proBNP and cardiac ultrasound indexes were compared between the two groups. Results The observation group's serum cTnT and NT-proBNP were (0.332±0.066) ng/mL and (304.33±54.37) ng/mL, respectively; the control group's serum cTnT and NT-proBNP were (0.184±0.052) ng/mL, (264.73±43.94) ng/mL; comparing the two groups of cTnT(t=4.207, P<0.05); comparing the two groups of NT-proBNP(t=5.886, P<0.05). observation group LAD (36.95±2.15) mm, LVDd (52.83± 4.62) mm, IVST (13.84±2.55) mm, LVEF (52.49±7.56)%; control group LAD (35.63±2.06) mm, LVDd (48.43±5.03) mm, IVST (10.94±2.13) mm, LVEF (56.84±8.05)%; comparing the two groups of LAD(t=2.592, P<0.05); comparing the two groups of LVDd(t=2.883, P<0.05); comparing the two groups of IVST(t=2.904, P<0.05); comparing the two groups of LVEF(t=3.206, P<0.05). Conclusion The use of serum cTnT and NT-proBNP detection combined with cardiac ultrasound in HD patients can determine whether there is a risk of cardiovascular events as soon as possible. According to the test results, timely assessment and active intervention can avoid or reduce the occurrence of cardiovascular events.
綜上所述,HD患者應(yīng)用血清cTnT與NT-proBNP檢測(cè)聯(lián)合心臟超聲檢查,可盡早明確有無(wú)心血管事件風(fēng)險(xiǎn),根據(jù)檢測(cè)結(jié)果及時(shí)評(píng)估,積極干預(yù),可避免或減少心血管事件發(fā)生。
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(收稿日期:2020-06-12)
[作者簡(jiǎn)介] 林秀玉(1984-),女,本科,醫(yī)師,研究方向:心臟。
[通信作者] 楊斌(1959-),男,博士,主任醫(yī)師,E-mail: yb12yx@ hotmail.com。