Résumé
ObjectiveTo investigate the predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP) level on the capacity load of patients with maintenance hemodialysis (MHD).MethodsOne hundred and twenty patients undergoing MHD were divided into two groups according to blood pressure levels:bad blood pressure control group with 72 patients and good blood pressure control group with 48 patients.NT-proBNP levels were detected before and after dialysis,and cardiothoracic ratio,left ventricular mass index ( LVMI ),swelling index,number of occurrences of low blood volume and ultrafiltration volume were measured and compared between two groups.The correlation between NT-proBNP and the above indicators was analyzed.ResultsThe systolic blood pressure,diastolic blood pressure,NT-proBNP before dialysis,cardiothoracic ratio,LVMI,swelling index and number of occurrences of low blood volume in bad blood pressure control group respectively were (159.7±18.2) mm Hg (1 mm Hg =0.133 kPa),(95.3±14.8) mm Hg,(11 837.13±1374.26) ng/L,0.61±0.12,(174.36±21.35) g/m2,2.93±1.72,12cases/week,while the indicators in good blood pressure control group were ( 131.6±17.3) mm Hg,(86.5±13.2) mm Hg,(7649.54±1106.18) ng/L,0.52±0.11,( 151.83±18.94) g/m2,1.02±1.48,26 cases/sweek.There were significant differences between two groups (P ＜ 0.01 ).It was showed that NT-proBNP difference between before and after dialysis had significant positive correlation with ultrafiltration volume(P＜ 0.05).NT-proBNP before dialysis had a significant positive correlation with systolic blood pressure,diastolic blood pressure,cardiothoracic ratio,LVMI and swelling index (P ＜ 0.05 or ＜ 0.01 ),while had obvious negative correlation with the number of occurrences of low blood volume(P ＜ 0.01 ).ConclusionsNT-proBNP level of MHD patients has close correlation with blood pressure,cardiothoracic ratio,swelling index,number of occurrences of low blood volume and ultrafiltration volume.Detecting the level of NT-proBNP can better evaluate the changes of blood volume in dialysis patients,adjust dialysis prescription in time,and ensure the adequacy of dialysis.It has important significance to improve the quality of life of MHD patients.