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目的:探讨丙肝病毒性肝硬化及非酒精性脂肪肝患者血清脑钠肽(BNP)水平与肝脏疾病严重程度及心脏功能的相关性。方法:选取丙肝病毒性肝硬化患者55例为肝硬化组,非酒精性脂肪肝患者55例为脂肪肝组,健康志愿者25例为对照组。对3组研究对象进行完整的体格检查,测定血红蛋白水平、肝肾功能生化指标、BNP,通过心电图、超声心动图检查心脏功能指标。结果:肝硬化组患者血清BNP水平显著高于其余两组(P<0.05),并与肝脏疾病严重程度相关(P<0.05);代谢失代偿的肝硬化患者BNP水平显著高于无失代偿的患者;脂肪肝组患者血清BNP水平较对照组差异无统计学意义,且与脂肪肝严重程度无相关性。二维心脏彩超检查显示室间隔厚度(IVST)>11 mm、舒张期后壁厚度(PWT)>11 mm、左心房内径(LA)>40 mm、左心室射血分数(EF)<54%以及左室早期舒张充盈峰值速度与心房收缩晚期充盈波峰值速率的比值(E/A值)<1的肝硬化和脂肪肝患者血清BNP水平显著高于未出现上述情况的患者(P<0.05)。结论:血清BNP水平与肝硬化严重程度及心脏功能变化存在相关性,其对肝病严重程度及心脏功能的监测具有重要意义。
Objective: To investigate the relationship between serum brain natriuretic peptide (BNP) levels and the severity of liver disease and cardiac function in patients with hepatitis C virus cirrhosis and non-alcoholic fatty liver disease. Methods: Fifty-five patients with hepatitis C cirrhosis were selected as cirrhosis group, 55 patients with non-alcoholic fatty liver disease as fatty liver group and 25 healthy volunteers as control group. The three groups of subjects to conduct a complete physical examination, hemoglobin levels, liver and kidney biochemical markers, BNP, by electrocardiogram, echocardiography examination of cardiac function. Results: Serum BNP levels in patients with cirrhosis were significantly higher than those in the other two groups (P <0.05), and were correlated with the severity of liver disease (P <0.05). BNP levels in patients with decompensated liver cirrhosis were significantly higher than those in patients without liver cancer Patients with fatty liver; serum BNP levels in patients with fatty liver compared with the control group was no significant difference, and no correlation with the severity of fatty liver. Two-dimensional echocardiography showed that IVST> 11 mm, PWT> 11 mm, LA> 40 mm, LV ejection fraction <54% and Serum BNP levels in patients with cirrhosis and fatty liver were significantly higher than those without (P <0.05), indicating that the ratio of the peak LV diastolic filling velocity to the peak filling velocity of the atrial appendage wave (E / A value <1) Conclusion: There is a correlation between the level of serum BNP and the severity of cirrhosis and changes of cardiac function. It is of great significance to the severity of liver disease and the monitoring of cardiac function.