B型利钠肽在肝硬化性心肌病中的作用进展

Advances in the effect of B-type natriuretic peptide and its significance in patients with cirrhotic cardiomyopathy

肝硬化患者常见有心脏负荷增大,心肌收缩功能和舒张功能受损,导致心肌结构异常,当处于应激状态时可出现心力衰竭症状,被称为肝硬化性心肌病(CCM)。由于起病隐匿,目前对于CCM关注较少。B型利钠肽(BNP)由心肌细胞分泌,能够敏感地反映心室功能变化,被广泛应用于心血管疾病的发病、治疗及预后等方面的评估。BNP一直以来在呼吸系统疾病、肾脏疾病的诊疗方面均显示出重要作用,同时近期研究发现BNP在肝硬化患者中明显升高,与肝硬化腹水、静脉曲张、肝功能损伤严重程度紧密相关,并且在CCM无症状时,即可对心肌损伤发挥一定的提示作用。综述了BNP在CCM中的表达及意义。

Cirrhotic patients often have an increased cardiac load and impaired myocardial systolic and diastolic functions,which further cause abnormal myocardial structure,and such patients may develop the symptoms of heart failure under stress,which is called cirrhotic cardiomyopathy （CCM）.This disease attracts little attention due to its insidious onset.B-type natriuretic peptide （BNP） is secreted by cardiomyocytes and can sensitively reflect the change in ventricular function,and it is widely used in the pathogenesis,treatment,and prognosis of cardiovascular diseases.BNP plays an important role in the diagnosis and treatment of respiratory and renal diseases,and meanwhile,recent studies have shown a significant increase in BNP in cirrhotic patients,which is closely associated with the severity of cirrhotic ascites,varices,and liver dysfunction.BNP can also reveal myocardial injury when there are no obvious symptoms of CCM.This article reviews the expression of BNP and its significance in patients with CCM.