邮件订阅 RSS 中文 | English
高级检索

非透析慢性肾脏病患者sST2、NT-proBNP、hs-cTnT与左心室构型的相关性

Correlations between sST2, NT-proBNP, hs-cTnT and left ventricular geometry in patients with chronic kidney disease

    摘要
  • 摘要:
    目的 探讨慢性肾脏病（chronic kidney disease，CKD）患者可溶性生长刺激表达基因2蛋白（soluble growth stimulation expressed gene 2 protein，sST2）和传统心脏标志物与左心室构型的相关性。
    方法 纳入2019年8月至2020年12月在复旦大学附属中山医院肾内科诊治的非透析CKD患者。收集患者临床资料，检测心脏标志物sST2、N端脑钠肽前体（N-terminal pro-B-type natriuretic peptide，NT-proBNP）、高敏心肌肌钙蛋白T（high-sensitivity cardiac troponin T，hs-cTnT）。采用经胸超声心动图评估左心室结构，根据左心室质量指数（left ventricular mass index，LVMI）和相对室壁厚度（relative wall thickness，RWT）定义左心室几何构型。采用事后检验分析各左心室构型患者间心脏标志物差异。采用多元线性回归分析心脏标志物与心脏结构参数之间的相关性。
    结果 共纳入CKD患者652例，左心室肥厚（left ventricular hypertrophy，LVH）的检出率为33.4%；LVH检出率随肾功能恶化而升高，在CKD 5期患者中为64.3%。与正常左心室构型患者相比，NT-proBNP和hs-cTnT水平在向心性及离心性LVH患者中均升高（P < 0.001），sST2水平仅在向心性LVH患者中升高（P=0.025）。多元线性回归分析示，sST2与左心房内径、LVMI相关（P < 0.01）；NT-proBNP与左心房内径、左心室舒张末期内径、左心室收缩末期内径、后壁厚度、室间隔厚度、左心室射血分数、左心质量和LVMI有一定相关性（P < 0.000 1）；hs-cTnT与左心房内径、后壁厚度、室间隔厚度、左心质量、RWT和LVMI有一定相关性（P < 0.01）。
    结论 sST2在存在向心性LVH的CKD患者中明显升高，而在离心性LVH患者中变化不明显，不同于传统心脏标志物。

     

    Abstract:
    Objective To investigate the associations between soluble growth stimulation expressed gene 2 protein (sST2), conventional biomarkers and left ventricular geometry in patients with chronic kidney disease (CKD).
    Methods Patients with non-dialysis-dependent CKD in Department of Nephrology, Zhongshan Hospital, Fudan University were enrolled from August 2019 to December 2020. Clinical data were collected, and serum sST2, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) were measured. Left ventricular structure was assessed by transthoracic echocardiography. Left ventricular geometric patterns were defined according to left ventricular mass index (LVMI) and relative wall thickness (RWT). Differences of cardiac biomarkers between different left ventricle geometric groups were analyzed with Tukey's post-hoc test. Multiple linear regression models were used to evaluate the correlations between biomarkers and cardiac structure parameters.
    Results A total of 652 patients with CKD were enrolled, and the detection rate of LVH was 33.4%. The detection rate of LVH increased as kidney function worsened, with 64.3% in CKD G5 patients. Compared with normal geometry group, NT-proBNP and hs-cTnT levels elevated in both concentric LVH (cLVH) and eccentric LVH (eLVH) patients (P < 0.001), while sST2 level only elevated in the cLVH patients (P=0.025). Multiple linear regression analysis showed that sST2 was associated with LAD and LVMI (P < 0.01); NT-proBNP was associated with left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), posterior wall thickness (PWT), interventricular septum thickness (IVST), left ventricular ejection fraction (LVEF), left ventricular mass (LVM), and LVMI (P < 0.000 1); hs-cTnT was associated with LAD, PWT, IVST, LVM, RWT and LVMI (P < 0.01).
    Conclusions sST2 could increase in CKD patients with cLVH, while has not significant change in eLVH patients, which is different from NT-proBNP and hs-cTnT.

     

    • HTML全文
    • 参考文献(40)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回