肝硬化患者血浆前脑利钠肽水平变化及其临床意义

目的探讨血浆前脑利钠肽（proBNP）对肝硬化心肌病的判断价值。方法对38例肝硬化患者（LC组）和20名健康体检者（CG组），用ELISA法测定血浆proBNP水平，并行心电图检查。比较两组proBNP水平及心电图改变（QTc、QTd、QTcd和Pd）的差异；对肝硬化患者，分析心电图改变与CTP积分、MELD评分、proBNP的关系。结果Lc组proBNP水平为（228．0±83．4）fmol／ml，显著高于CG组（127．4±21．1）fmol／ml。LC组QTc、QTd、QTcd、Pd分别为（446．9±28．0）ms1/2、（36．4±6．6）ms、（40．6±9．0）ms1/2、（22．8±4．8）ms，均显著长于CG组（417．2±21．5）ms1/2、（29．6±4．9）ms、（31．1±4．9）ms1/2、（19．0±4．1）ms，且与CTP、MELD、proBNP水平呈正相关。结论肝硬化患者存在心肌受损，血浆proBNP可较好地反映肝硬化心肌病病情。

The change of plasma pro B-type natriuretic peptide level and its clinical significance in patients with liver cirrhosis

Objective To investigate the value of plasma pro B-type natriuretie peptide level in diagnosis of cirrhotic cardiomyopathy（CCM）. Methods Plasma proBNP levels,the changes on ECG（QTc,QTd,QTcd and Pd） were measured and evaluated in 38 patients with cixThosis and 20 healthy controls, and compared between the two groups. In patients with cirrhosis, the association between the changes on ECG and CTP score, MELD score, proBNP levels were analyzed. Results ProBNP was significantly higher in patients with cirrhosis （228.0 ± 83.4） fmol/ml than in healthy controls（ 127.4±21.1 ）fmol/ml. And in patients with cirrhosis,the changes on ECG, QTc,QTd, QTcd and Pd, were （446. 9± 28.0） mst/Z, （ 36.4 ± 6. 6 ） ms, （40. 6 ± 9. 0） msV2, （ 22. 8 ±4. 8 ） ms respectively and significantly increased compared with healthy subjects （417.2 ± 21.5 ） ms1/2, （29. 6 ± 4. 9 ） ms, （ 31.1±4. 9 ） ms1/2, （ 19. 0± 4. 1 ） ms, and positively related to CTP score, MELD score and proBNP level. Conclusion The plasma level of proBNP was valuable for diagnosis of CCM, and correlated with the severity of CCM.