中国医科大学学报

中国医科大学学报

中国医科大学学报

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肝硬化患者血浆B 型利尿肽水平的变化及其临床意义

王莹,刘维新,邢俊伟,周凤,于艳红,王婷   

  1. 中国医科大学附属第一医院消化内科,沈阳110001
  • 收稿日期:2015-09-21 出版日期:2016-01-05 发布日期:2015-12-30
  • 通讯作者: 刘维新,E-mail:weixinliu@yahoo.com
  • 作者简介:王莹(1989 -),女,硕士研究生.
  • 基金资助:

    辽宁省科学技术计划项目(2013225303)

Changes of Plasma B-type Natriuretic Peptide in Patients with Liver Cirrhosis and Its Clinical Significance

WANG Ying,LIU Wei-xin,XING Jun-wei,ZHOU Feng,YU Yan-hong,WANG Ting   

  1. Department of Digestive Diseases,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2015-09-21 Online:2016-01-05 Published:2015-12-30

摘要:

目的 检测肝硬化患者血浆B型利尿肽(BNP)水平,分析其与肝功能分级、消化道出血、肝硬化腹水、血红蛋白、肾功能、凝血功能的关系。方法 选取我院收治的肝硬化患者161例为实验组,同时选取161例健康体检者作为对照组。收集基本信息,测定血浆BNP、血红蛋白、肾功能、凝血功能及是否合并消化道出血和肝硬化腹水。观察实验组与对照组血浆BNP水平是否存在差异,实验组中不同性别、年龄、肝功能分级以及是否合并消化道出血、腹水等并发症时BNP水平的变化,以及BNP水平与血红蛋白、肾功能、凝血功能、便潜血结果的相关性。结果 实验组血浆BNP水平较对照组升高(P < 0.05)。实验组中,不同年龄及性别间血浆BNP水平无明显差异(P > 0.05);Child-Pugh C级患者血浆BNP水平明显高于Child-Pugh A级和B级患者,且Child-Pugh B级患者高于Child-Pugh A级患者(P < 0.05)。实验组中合并消化道出血、腹水、贫血、便潜血阳性、肾功能异常的患者,血浆BNP高于不合并上述症状的患者(P < 0.05)。实验组中血浆BNP水平与血红蛋白、肌酐、胱抑素C、血尿素氮呈正相关,与血浆凝血酶原时间、活化的部分凝血活酶时间、纤维蛋白原无相关性。结论 血浆BNP水平同性别、年龄等基本因素无关。BNP水平可反映肝硬化患者病情的严重程度,并且受消化道出血、肝硬化腹水、贫血、肾功能异常等因素的影响。BNP对肝脏合成功能无明显影响。

关键词: B型利尿肽, 肝硬化, 消化道出血, 腹水, 血红蛋白, 肾功能

Abstract:

Objective To determine the relationships of plasma level of B-type natriuretic peptideBNPwith liver function classificationgastrointestinal bleedingliver cirrhosis asciteshemoglobinrenal functionand coagulation function. Methods A total of 161 patients with liver cirrhosis admitted to our hospital were selected as the experimental groupand 161 healthy individuals were enrolled as the control group. Plasma BNPhemoglobinrenal functionblood coagulation functionand complications of gastrointestinal bleeding and ascites were evaluated. The changes in BNP levels in patients with different levels of liver functiongastrointestinal bleedingascitesand other complications were determinedand the correlations of BNP level with hemoglobinrenal functionand blood coagulation function were analyzed. Results The plasma levels of BNP were higher in experimental group than in control groupP < 0.05. There was no significant difference in plasma levels of BNP between different ages or genders in the experimental groupP > 0.05. The patients with Child-Pugh C score had the highest level of BNPand the BNP level in patients with Child-Pugh B score was higher than that in patients with Child-Pugh A scoreP <0.05.In patients with gastrointestinal bleedingascitesanemiaandrenal dysfunctionplasma BNP was higher than those without the above symptomsP < 0.05. Plasma BNP levels in patients with liver cirrhosis were positively correlated with hemoglobincreatininecystatin Cand urea nitrogenbut not with PTAPTTor plasma fibrinogen levels. Conclusion Age and gender have no significant effect on plasma BNP level. BNP level can reflect the severity of the disease in patients with cirrhosisand is affected by the factors such as gastrointestinal bleedingascitesanemiaand renal dysfunction. There is no obvious effect of BNP on liver synthetic function.

Key words: B-type natriuretic peptide, liver cirrhosis, gastrointestinal bleeding, ascites, hemoglobin, renal function

中图分类号: 

  • R575.2
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