| 郭宝珠,王琳琳,潘 星,卫志锋,何丽莎.肾病综合征患者血清同型半胱氨酸、D-二聚体和B型钠尿肽水平表达及与血栓栓塞的关系分析[J].,2021,(10):1992-1996 |
| 肾病综合征患者血清同型半胱氨酸、D-二聚体和B型钠尿肽水平表达及与血栓栓塞的关系分析 |
| Expression of Serum Homocysteine, D-dimer and B-type Natriuretic Peptide in Nephrotic Syndrome and Its Relationship with Thromboembolism |
| 投稿时间：2021-01-03 修订日期：2021-01-26 |
| DOI：10.13241/j.cnki.pmb.2021.10.041 |
| 中文关键词: 肾病综合征 血栓栓塞 同型半胱氨酸 D-二聚体 B型钠尿肽 影响因素 |
| 英文关键词: Nephrotic syndrome Thromboembolism Homocysteine D-dimer B-type natriuretic peptide Influencing factors |
| 基金项目:国家自然科学基金项目（81173078）；河北省技术创新引导计划项目（20477705D） |
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| 中文摘要: |
| 摘要 目的：探讨肾病综合征（NS）患者血清同型半胱氨酸（Hcy）、D-二聚体（D-D）和B型钠尿肽（BNP）水平及与发生血栓栓塞（TE）的关系。方法：选取2017年1月~2019年1月我院收治的241例NS患者，根据是否并发TE分为TE组56例，非TE组185例，另选取65名体检健康者为对照组，对比各组血清Hcy、D-D和BNP水平，多因素Logistics回归分析NS患者并发TE的影响因素，ROC曲线判断血清Hcy、D-D和BNP水平对NS患者并发TE的诊断价值。结果：三组血清Hcy、D-D和BNP水平比较差异有统计学意义（P＜0.05）。TE组血清Hcy、D-D和BNP水平明显高于非TE组，非TE组血清Hcy、D-D和BNP水平明显高于对照组，差异均有统计学意义（P＜0.05）。TE组高血压史、利尿剂使用史、糖皮质激使用史比例和BUN、24hUPQ水平明显高于非TE组，差异均有统计学意义（P＜0.05）。多因素Logistics回归分析显示，Hcy、D-D、BNP、24hUPQ为NS患者并发TE独立影响因素（P＜0.05）。ROC曲线显示，血清Hcy+D-D+BNP水平诊断NS患者并发TE的AUC明显大于血清Hcy、D-D和BNP单独诊断，敏感度和特异度也高于各指标单独诊断。结论：NS患者血清Hcy、D-D和BNP水平明显提升，合并TE后进一步提高，且血清Hcy、D-D和BNP水平为NS患者发生TE的危险因素，联合测定可提高诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the levels of serum homocysteine(Hcy), D-Dimer(D-D) and B-type natriuretic peptide(BNP) in patients with nephrotic syndrome(NS) and their relationship with thromboembolism (TE). Methods: 241 patients with NS admitted to our hospital from January 2017 to January 2019 were selected and divided into TE group (n=56) and non TE group (n=185) according to whether they were complicated with TE or not. Another 65 healthy people were selected as the control group. The levels of serum Hcy, D-D and BNP in each group were compared.The influencing factors of NS patients complicated with TE were analyzed by multivariate logistic regression. Results: There were significant differences in serum Hcy, D-D and BNP levels among the three groups(P<0.05). The serum levels of Hcy, D-D and BNP in TE group were significantly higher than those in non TE group. The serum levels of Hcy, D-D and BNP in non TE group were significantly higher than those in control group (P<0.05). The proportion of history of hypertension,history of diuretic use, history of glucocorticoid use, BUN and 24hUPQ levels in TE group were significantly higher than those in non TE group(P<0.05). Multivariate logistic regression analysis showed that Hcy, D-D, BNP and 24hUPQ were independent influencing factors of NS patients complicated with TE (P<0.05). ROC curve showed that the AUC of serum Hcy+D-D+BNP level in diagnosing NS patients complicated with TE was significantly higher than that of serum Hcy, D-D and BNP alone, and the sensitivity and specificity were also higher than that of each index alone. Conclusion: The serum levels of Hcy, D-D and BNP in patients with NS were significantly increased, and further increased after combined with TE. The serum levels of Hcy, D-D and BNP were risk factors for the occurrence of TE in patients with NS, and combined detection can improve the diagnostic value. |
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