非透析慢性肾脏病患者心脏功能生物标记物的临床价值比较

目的:比较非透析慢性肾脏病患者心脏功能生物标记物的临床应用价值。方法:选取122例非透析且无急性冠脉综合征(ACS)的慢性肾脏病患者(CKD),将其分为CKD1-2期组、CKD3-4期组和CKD5期组,同时选择同期确诊急性冠脉综合征的慢性肾脏病患者20例作为对照组,观察并比较各组患者室间隔厚度(IVST)、左室后壁厚度(LVPWT),检测血液中血肌酐(Scr)、尿素氮(BUN)、心型脂肪酸结合蛋白(HFABP)、心肌钙蛋白(cTnI)以及肌酸激酶同功酶(CK-MB)。结果:非ACS的CKD患者HFABP、cTnI、CK-MB水平均呈不同程度增高,且各CKD组中这三个指标的阳性率存在显著差异,其中HFABP阳性率最高(P0.05)。cTnI与e GFR、Scr及年龄无显著相关性(P0.05),但与IVST、LVPWT呈显著正相关(P0.05);CK-MB与e GFR、Scr、年龄、IVST、LVPWT均无相关性(P0.05);HFABP与e GFR呈负相关(P0.05),与Scr和BUN正相关(P0.05),与年龄、IVST、LVPWT无相关性(P0.05)。结论:在非ACS的CKD患者中,HFABP可能不是一个可靠的反映心脏功能的生物标记物,cTnI及CK-MB对于CKD患者而言是较为可靠的心脏标记物。

Comparison of the Clinical Significances of Cardiac Function Biomarkersin Patients with Non-dialysis Chronic Kidney Disease

Objective:To compare the cardiac biomarkers in chronic kidney disease patients without dialysis.Methods:122non-dialysis CKD patients without ACS were included in the study, and they were divided into the CKD1-2 group, the CKD3-4 groupand the CKD5 group based on the value of eGFR. Choose 20 cases ACS patients with chronic kidney disease in the same period as controlgroup, All the patients were examined by echocardiographic examination, recording interventricular septal thickness (IVST) and leftventricular posterior wall thickness (LVPWT); Blood samples were taken for measurement of blood urea nitrogen (BUN), Serum creatinine(Scr), heart-type fatty acid binding protein (HFABP), cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB).Results:TheHFABP, cTnI and CK - MB were increased to some extent in the 122 patients, and there were statistically significant differences aboutthe positive rates of HFABP, cTnI and CK - MB in the three groups, and the HFABP was the highest (P<0.05). There was no correlationof cTnI with the eGFR, Scr and age (P>0.05); There was positively correlation of cTnI with IVST and LVPWT (P<0.05); There was nocorrelation of CK-MB with eGFR, Scr, age, IVST and LVPWT (P>0.05); There was negatively correlation of HFABP with eGFR, andpositively correlation with Scr and BUN(P<0.05); There was no correlation of HFABP with age, IVST and LVPWT (P>0.05).Conclusion:HFABP is not an ideal myocardial marker in CKD patients without ACS; cTnI and CK-MB could be a reliable myocardial marker forchronic kidney disease.