血液透析前后血浆B型钠尿肽变化及对心力衰竭的诊断价值临床医学.doc

血液透析前后血浆B型钠尿肽变化及对心力衰竭的诊断价值临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：血液透析前后血浆B型钠尿肽变化及对心力衰竭的诊断价值临床医学 1 1 资料与方法 3 2 结果 4 3 讨论 4 文2：血浆B型钠尿肽对心力衰竭的影响 6 1 材料与方法 6 2 结果 7 3 讨论 7 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 10 正文 血液透析前后血浆B型钠尿肽变化及对心力衰竭的诊断价值临床医学 文1：血液透析前后血浆B型钠尿肽变化及对心力衰竭的诊断价值临床医学 【Abstract】 Objective To investigate the change of B-type natriuretic peptide(BNP) levels before and after dialysis its diagnostic value for heart failure . Methods The BNP levels were determined in 56 patients of chroic renal failure before and after dialysis and in 30 healthy people as control. Results The BNP levels in 56 patients before dialysis, and right, 3 hou, 6 hou, 24 hou after dialysis were (284±369) pg/ml，(371±425) pg/ml，(265±308) pg/ml，(204±242) pg/ml, (230±288) pg/ml respectively（P）.The BNP levels were （595±438） pg/ml in patients with heart dysfunction，（98±110） pg/ml in patients without heart dysfunction and （37±37） pg/ml in healthy people（P）.The biggest ROC area of BNP diagnosing heart failure in patients with dialysis was at 6 hou after dialysis. BNP had a seibility of and specificity of to diagnose heart failure in patients with dialysis at a cutoff value of 99pg/ml, and a seibility of and specificity of at a cutoff value of 225pg/ml. Conclusio The BNP levels are higher in patients with dialysis than those in healthy people, regardless of patients heart function and have a process of temperary increasing ,then decreasing and increasing of BNP in patients with dialysis contributes to the diagnosis of heart dysfunction and that at the time point 6h after dialysis has the best diagnositc value. BNP lower than 99 pg/ml can help to exclude heart failure and contributes to heart failure diagnosis when higher than 225 pg/ml. 【Key Words】 B-type natriuretic peptide Chronic ranal dysfunction Dialysis heart failure B型钠尿肽（B-type natriuretic peptide, BNP）是由心脏分泌的神经激素，在心室容积增加和压力超负荷时分泌增多，用于检测左室收缩或舒张功能不全［１，２］。慢性肾功能不全由于水钠潴留和代谢产物排出障碍，BNP水平增高［３］，影响伴有心功能不全患者的检出，