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目的通过观察糖尿病慢性肾脏疾病(CKD)患者厄贝沙坦治疗后血浆氨基末端脑钠肽前体(NT-proBNP)水平变化,探讨NT-proBNP在CKD患者中的临床意义。方法选择T2DM患者167例,根据尿白蛋白/肌酐比值(UACR)分为大量白蛋白尿(A)组(UACR≥300mg/g)54例、微量白蛋白尿(B)组(30mg/g≤UACR<300mg/g)60例、尿白蛋白正常者(C)组53例。所有研究对象给予厄贝沙坦150mg/g,连续24周。比较各组治疗前后NT-proBNP水平变化及其与Cr、UACR变化的关系。结果经厄贝沙坦治疗后,A、B组NT-proBNP下降(P<0.01)。A、B组NT-proBNP与UACR、Cr呈正相关(r=0.730、0.546,P=0.000)。结论厄贝沙坦降低CKD患者尿蛋白的同时伴NT-proBNP水平下降,提示NT-proBNP可能成为诊断早期CKD的标志物及评估CKD治疗效果的辅助手段之一。
Objective To investigate the clinical significance of NT-proBNP in patients with CKD by observing the change of plasma NT-proBNP level in patients with chronic kidney disease (CKD) after irbesartan treatment. Methods A total of 167 patients with T2DM were enrolled. According to the urinary albumin / creatinine ratio (UACR), 54 patients with massive albuminuria (UACR≥300mg / g) and 30mg / g≤ UACR <300mg / g) 60 cases, normal urine albumin (C) group of 53 cases. All subjects were given irbesartan 150mg / g for 24 weeks. The changes of NT-proBNP levels and the changes of Cr, UACR in each group before and after treatment were compared. Results After treatment with irbesartan, NT-proBNP decreased in group A and group B (P <0.01). There was a positive correlation between NT-proBNP and UACR and Cr in group A and group B (r = 0.730, 0.546, P = 0.000). Conclusions Irbesartan can reduce the urinary protein in patients with CKD accompanied with the decrease of NT-proBNP level, suggesting that NT-proBNP may be a useful marker for early diagnosis of CKD and an adjunct to evaluate the therapeutic effect of CKD.