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目的观察肝硬化患者血浆氨基末端B型尿钠肽前体、血清一氧化氮和血红蛋白的变化及相关性。方法测定58例肝硬化患者和30例健康对照的血浆氨基末端B型尿钠肽前体、一氧化氮和血红蛋白水平;同时按血红蛋白水平将肝硬化患者分为贫血组和非贫血组。结果肝硬化患者血浆氨基末端B型尿钠肽前体、一氧化氮明显高于健康对照组(P<0.01),血红蛋白水平明显低于健康对照组(P<0.01)。肝硬化患者贫血组血浆氨基末端B型尿钠肽前体明显高于非贫血组(P<0.05);肝硬化患者血浆氨基末端B型尿钠肽前体水平与一氧化氮呈正相关(P<0.05),与血红蛋白呈负相关(P<0.05)。结论肝硬化患者血浆氨基末端B型尿钠肽前体升高可能提示心功能不全,一氧化氮水平的升高和血红蛋白水平的降低可能参与了肝硬化患者心功能不全的病理生理过程。
Objective To observe the changes of plasma N-terminal pro-type natriuretic peptide, serum nitric oxide and hemoglobin in cirrhotic patients and their correlations. Methods The plasma levels of N-terminal pro-B-type natriuretic peptide, nitric oxide and hemoglobin were measured in 58 patients with cirrhosis and 30 healthy controls. Patients with cirrhosis were divided into anemia group and non-anemia group according to hemoglobin level. Results The levels of plasma N-terminal pro-brain natriuretic peptide and nitric oxide in patients with cirrhosis were significantly higher than those in healthy controls (P <0.01), and hemoglobin levels were significantly lower in patients with cirrhosis than those in healthy controls (P <0.01). The level of plasma N-terminal pro-B-type natriuretic peptide in patients with cirrhosis was significantly higher than that in non-anemic patients (P <0.05). The level of plasma N-terminal pro-type natriuretic peptide in cirrhotic patients was positively correlated with nitric oxide (P < 0.05), and negatively correlated with hemoglobin (P <0.05). Conclusions The elevation of plasma N-terminal pro-B-type natriuretic peptide precursor in patients with cirrhosis may be indicative of cardiac dysfunction. Elevated levels of nitric oxide and hemoglobin may play a role in the pathophysiology of cardiac dysfunction in cirrhotic patients.