活体肝移植患者围术期血清NT-proBNP变化的临床分析

Clinical study of serum NT - proBNP levels in adult patients undergoing live donor liver transplantation

目的研究活体肝移植患者围术期血清氨基末端-脑钠肽前体（N—terminalpro—brainnatriureticpeptide，NT—proBNP）的变化规律。方法肝移植受者32例，静吸复合全麻下行活体部分肝移植术。分别于切皮前即刻（T0）、无肝期30min（T1）、新肝期30min（T2）、术毕（T3）、术后24h（T4）和术后48h（T，）采集中心静脉血样，检测血清NT—proBNP、肌钙蛋白I（cTnI）和肌酸激酶同工酶（CK—MB）浓度。结果与Tn时比较，T：-L时血清NT—proBNP、cTnI浓度和CK—MB浓度显著升高（P〈0．01，P〈0．05）。结论活体肝移植患者围术期血清NT—proBNP浓度变化显著，从新肝期至术后48h持续升高，提示肝移植围术期存在着-定程度的心肌损伤。

Objective To investigate the characteristics of serum N - terminal pro - brain natriuretie peptide （ NT - proBNP） in adults undergoing living donor liver transplantation （LDLT）. Methods 32 recipients who underwent right lobe adult - to - adult LDLT received general anesthesia. Blood samples were drawn from central vein before skin incision （To baseline） , at 30 min of anhepatic phase （T1 ） , 30 min of neohepatic phase （T2 ） , the end of surgery （T3 ） and 24, 48 h after operation （ Ta,s ）. Levels of NT - proBNP, cardiac troponin I （cTnI） and creatine kinase MB （ CK - MB ） were measured. Results The NT- proBNP, cTnl and CK- MB at T2 -T5 increased significantly compared with the baseline at To （ P 〈 0. 05, P 〈 0.01 ）. Conclusion The serum NT - proBNP increased significantly in patients undergoing LDLT from neohepatic phase to first 48 h after operation, which may imolv some degree of myocardial injury caused bv LDLT.