在SPRINT中,尿水平的变化和随后的功能下降
Simon B Ascher1, Jarett D Berry2, Ronit Katz3
1Kidney Health Research Collaborative, Department of Medicine, San Francisco Veterans Affairs Health Care System and University of California San Francisco, San Francisco; Division of Hospital Medicine, University of California, Davis, Sacramento.
概括
在血压治疗期间,N-终端B型亲尿素 (NT-proBNP) 的变化预测功能下降. 增加NT-proBNP与更快的功能丧失有关,特别是在慢性病 (CKD) 患者中.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 生物标志物研究 生物标志物研究
背景情况:
- 高血压管理需要更好的方法来预测病风险.
- 密集降低血压对脏结果的影响仍然不确定.
- N-终端亲B型尿性 (NT-proBNP) 反映了心脏压力,可能表明风险.
研究的目的:
- 调查在高血压治疗期间纵向NT-proBNP变化和功能下降之间的关联.
- 评估NT-proBNP变化是否可以作为病风险的动态标记.
主要方法:
- 预期观察性研究,对8005名参与者进行了系统性血压干预试验 (SPRINT).
- 测量包括基线和1年的NT-proBNP,并对NT-proBNP变化进行分类 (下降,增加,稳定).
- 用线性混合效应和逻辑回归模型评估估计的淋巴球过率 (eGFR) 变化,根据基线慢性病 (CKD) 状态分层.
主要成果:
- 在患有和没有CKD的参与者中,NT-proBNP下降≥25%与较慢的eGFR下降有关.
- 在NT-proBNP中≥25%的增加与更快的eGFR下降和≥30%eGFR下降的风险增加有关,特别是在患有CKD的参与者中.
- 这些关联独立于基线功能和血压治疗强度.
结论:
- 在血压治疗期间NT-proBNP的变化与随后的功能下降独立相关.
- NT-proBNP成为监测风险的潜在动态工具,特别是在患有CKD的患者中.
- 进一步的研究应该评估常规NT-proBNP测量对管理高血压相关病的有用性.
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