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目的:探讨心肾综合征(cardiorenal syndrome,CRS)患者超声心动图变化及全血脑钠肽(brain natriuretic peptide,BNP)、胱抑素C(Cystatin C,Cys-C)水平等与慢性肾脏病(chronic kidney disease,CKD)分期的关系。方法:我院肾内科符合标准的84例CRS患者,检测入院时的全血BNP、Cys-C水平,并检测超声心动图及心电图,收集相关参数进行分析。结果:CKD3、4、5期CRS患者之间,全血BNP、Cys-C水平有显著差异,各组之间左室舒张末期内径(LVDd)、左室后壁厚度(LVPW)、E峰、E/A、心率差异有统计学意义(P<0.05),而BNP和LVDd与CKD分期的相关性更加密切。结论:CKD 3~5期CRS患者心脏结构改变主要表现在左室舒张末期内径、左室后壁厚度增加等,心功能障碍主要表现在舒张功能受累。联合全血BNP、Cys-C水平、超声心动图及心电图检查可以作为观察CRS病情的有效指标,有利于预防及早期治疗。
Objective: To investigate the changes of echocardiography and the levels of brain natriuretic peptide (BNP) and Cystatin C (Cys-C) in patients with cardiorenal syndrome (CRS) and chronic kidney disease (chronic kidney disease, CKD) staging relationship. Methods: Eighty-four patients with CRS in our department were enrolled in this study. BNP and Cys-C levels of whole blood were measured at hospital admission. Echocardiography and electrocardiogram were detected and relevant parameters were collected for analysis. Results: The levels of BNP and Cys-C in whole blood of CKD patients with stage 3, 4 and 5 CRS were significantly different. The left ventricular end diastolic diameter (LVDd), left ventricular posterior wall thickness (LVPW), E peak, E / A, heart rate difference was statistically significant (P <0.05), while the correlation between BNP and LVDd and CKD stage more closely. CONCLUSION: The changes of cardiac structure in CRS patients with stages 3-5 CKD mainly manifest in diastolic diameter of left ventricle and thickness of posterior wall of left ventricle. Cardiac dysfunction is mainly manifested in diastolic dysfunction. Joint whole blood BNP, Cys-C levels, echocardiography and ECG can be used as an effective indicator of CRS disease, which is good for prevention and early treatment.