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目的观察BNP对维持性血液透析患者体内水负荷的判定价值。方法选取36例无尿的实施维持性血液透析的患者作为研究资料,36例患者实际体重均高于干体重,全部的患者经过3星期的透析脱水达到临床的干体重,对患者在达到干体重前后的BNP、下腔静脉内径(IVCD)、VCD值(IVCD/体表面积)、心胸比值(CRT)进行测定,并对患者的临床表现进行严密的观察。将选择的正常健康人群36人作为对照组。结果 (1)达到干体重之后患者的血浆BNP、心胸比、下腔静脉内径都比达干体重之前明显的降低了,经比较,有显著的统计学意义(P<0.01)。(2)和对照组患者进行比较,在患者达到干体重之前,患者的血浆BNP显著的比对照组患者要高,经比较,有显著的统计学意义(P<0.01),在患者达到干体重之后,其的血浆BNP和对照组比较,没有显著的差异。(3)患者在达干体重的前后的BNP之差和达到干体重前后的心胸比值(CRT)之差进行比较,差异显著(r=0.67,P<0.01);在达到干体重前后患者的BNP之差和达到干体重前后下腔静脉内径(VCD)之差比较,有显著的统计学意义(r=0.72,P<0.01)。结论测定患者的血浆BNP能够用在评估维持性血液透析患者的水负荷中,值得在临床中推广应用。
Objective To evaluate the value of BNP in predicting water load in maintenance hemodialysis patients. Methods Thirty-six patients without maintenance hemodialysis were enrolled in this study. The actual body weight of 36 patients was higher than that of the dry weight. All the patients underwent three-week dialysis dehydration to reach the clinical dry weight. The BNP, IVVD, IVVD / CRT and the clinical manifestations of the patients were observed. Thirty-six healthy individuals were selected as the control group. Results (1) The plasma BNP, cardiothoracic ratio and IVC diameter of the patients after DRG were significantly lower than those before DAD, and the difference was statistically significant (P <0.01). (2) Compared with the control group, the plasma BNP level of the patients before the patients reached the dry weight was significantly higher than that of the control group (P <0.01). After the patients reached the dry weight After its plasma BNP compared with the control group, there is no significant difference. (3) The difference of BNP before and after the up-to-dry weight and the difference between before and after reaching the dry weight were significant (r = 0.67, P <0.01). BNP The difference between the two groups was significant (r = 0.72, P <0.01). Conclusion The determination of plasma BNP in patients can be used in the assessment of water hemodialysis patients with water load, it is worth in the clinical application.