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BNP与NT-proBNP在伴有并发症的慢性肾病患者中的比较诊断效能

The comparative diagnostic efficacy of BNP & NT-proBNP in Chronic kidney disease patients with complications.

作者信息

Shaikh Saif Ullah, Yasmeen Ghazala, Rehman Rehana, Junejo Abdul Manan

机构信息

Saif Ullah Shaikh, MBBS, MSc, MPhil, PhD Student. Department of Physiology, University of Karachi, Karachi, Pakistan.

Ghazala Yasmeen, MSc, PhD. Assistant Professor, Department of Physiology, University of Karachi, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2025 Jul;41(7):1913-1917. doi: 10.12669/pjms.41.7.11826.

Abstract

OBJECTIVE

To study the differences between the B-type Natriuretic Peptide (BNP) and the N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) values in CKD patients due to diabetes and hypertension and without CKD. Another objective was to to observe what correlation the variables of age showed with the parameters of BNP, NT-proBNP values, and with Glomerular Filtration Rate (GFR).

METHODS

A case-control study was performed for six months between January to June 2024. In total 254 individuals took part in the study, with ages between 30-75 years, of which 85 were healthy controls and 169 CKD cases. CKD patients were recruited from the Department of Nephrology Jinnah Postgraduate Medical Centre (JPMC), Karachi. Diagnosis was made on the basis of raised serum urea, creatinine levels, and electrolyte imbalance. The following were excluded from participation: individuals with coronary artery disease, pregnancy, more than twice-weekly dialysis, or on steroid therapy. CKD cases were also staged according to National Kidney Foundation GFR guidelines.

RESULTS

Among the <50-year-old participants, BNP was abnormal in 92.7% of patients (p = 0.001), while NT-proBNP was abnormal in 38.5% (p = 0.01). When BNP and NT-proBNP were compared between the same individuals, BNP detected more abnormal cases, with a statistically significant difference (p = 0.01), indicating its better diagnostic yield in this group.

CONCLUSION

BNP was identified as a more authentic marker than NT-proBNP in order to detect cardiovascular stress in CKD patients. Its close correlation with increasing age and decreasing GFR highlights its prognostic significance and potential role in routine cardiovascular risk assessment in CKD populations.

摘要

目的

研究糖尿病和高血压所致慢性肾脏病(CKD)患者与非CKD患者的B型利钠肽(BNP)和N末端B型利钠肽原(NT-proBNP)值的差异。另一个目的是观察年龄变量与BNP、NT-proBNP值参数以及肾小球滤过率(GFR)之间的相关性。

方法

于2024年1月至6月进行了为期6个月的病例对照研究。共有254名年龄在30 - 75岁之间的个体参与研究,其中85名是健康对照者,169名是CKD病例。CKD患者来自卡拉奇真纳研究生医学中心(JPMC)肾脏病科。根据血清尿素、肌酐水平升高以及电解质失衡进行诊断。以下人员被排除在外:患有冠状动脉疾病、怀孕、每周透析超过两次或接受类固醇治疗的个体。CKD病例也根据美国国家肾脏基金会GFR指南进行分期。

结果

在<50岁的参与者中,92.7%的患者BNP异常(p = 0.001),而NT-proBNP异常的比例为38.5%(p = 0.01)。当在同一批个体中比较BNP和NT-proBNP时,BNP检测出的异常病例更多,差异具有统计学意义(p = 0.01),表明其在该组中的诊断效能更高。

结论

在检测CKD患者的心血管应激方面,BNP被确定为比NT-proBNP更可靠的标志物。其与年龄增长和GFR降低的密切相关性突出了其在CKD人群常规心血管风险评估中的预后意义和潜在作用。

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