肝硬化患者血浆B型利钠肽水平与肝功能状况的关系

目的观察肝硬化患者血浆B型利钠肽（B—type natriuretic peptide，BNP）浓度的变化，探讨肝硬化患者血浆BNP水平与肝功能状况及疾病严重程度的关系。方法检测50例肝硬化患者血浆BNP浓度、肝肾功能、心电图QTc间期（校正的QT间期）等。（1）所测BNP值与37例健康对照组进行比较；（2）不同Child Pugh分级者的BNP值进行两两比较；（3）BNP值与ChildPush积分、血清白蛋白水平、QTc间期进行相关分析。结果肝硬化组BNP值比健康对照组明显升高（P〈0．01），其中肝功能ChildA级者的BNP值与健康对照组比较差异处于临界值（P=0．092）。而Child B及Child C级者的BNP值均高于健康对照组，差异有统计学意义（P〈0．01）；BNP值在不同ChildPush分级间依次升高，而且Child A、B、C级三者间两两比较差异均有统计学意义（均P〈0．05）。BNP值与ChildPugh积分呈正相关（P〈0．01），与血清白蛋白呈负相关（P〈0．01），与QTc间期则无相关性。肝硬化组QTc间期延长20例（20／50），发生率为40％。结论肝硬化患者血浆BNP水平升高。并且与肝硬化的疾病严重程度相关，结合传统的ChildPush分级能正确反映肝硬化患者的肝功能状况。

The relationship between plasma B-type natriuretic peptide level and liver function in patients with cirrhosis

Objective To investigate the relationship between the plasma B-type natriuretic peptide (BNP) level and Child Pugh classification in patients with cirrhosis. Methods Plasma BNP levels,liver and kidney function and QTc intervals of 50 patients with cirrhosis were measured and evaluated. Plasma BNP levels of the patients with cirrhosis were compared among different Child Pugh grade groups and with those of controls. Correlation analysis of plasma BNP level with Child-pugh score, serum albumin level and QTc interval was performed. Results Plasma BNP levels of study group were significantly higher than those of controls (P<0.01). The difference of plasma BNP levels between Child A group and controls were not significant(P=0.092), while those of child B and child C groups were significantly higher than those of controls(P<0.01). The plasma BNP levels were elevated with the grade of Child-pugh classification. And the associations among these three groups were significant(P<0.05). Furthermore, the plasma concentrations of BNP were significantly related to Child-pugh score (P<0.01) and inversely related to serum albumin levels (P<0.01), while there was no correlation to QTc intervals. QTc intervals of 20 patients were prolonged(40%). Conclusion The elevated plasma BNP levels in patients with cirrhosis may reflect the severity of disease and can be used to evaluate the liver function.