血浆B型脑钠肽对乙型肝炎肝硬化失代偿期患者临床结局的评估价值

Clinical value of plasma BNP in the clinical outcome of decompensated liver cirrhosis patients

目的:探讨血浆B型脑钠肽(BNP)水平对乙型肝炎肝硬化失代偿期患者临床结局的评估价值。方法:选取2012年1月至2017年4月在我院接受治疗的乙型肝炎肝硬化失代偿期患者100例为研究对象,100例健康体检者作为对照。观察患者和对照组人员血浆BNP水平、肝功能、MELD评分的差异;比较肝硬化失代偿期患者不同合并症、1年生存者和死亡者血浆BNP水平、肝功能、MELD评分的差异。结果:肝硬化失代偿期患者的血浆BNP、ALT和AST水平均高于对照组(t=187. 630、59. 391、43. 130,P<0. 001);合并腹水者、合并肾功能损伤者和死亡者的BNP、ALT和AST水平较高(P <0. 001);肝硬化失代偿期患者的MELD评分明显高于对照组(t=52. 904,P <0. 001);合并腹水者、合并肾功能损伤者和死亡者的MELD评分较高(t=19. 071、22. 150、-19.163,P <0. 001)。结论:乙型肝炎肝硬化失代偿期患者的血浆BNP水平较高,且与患者是否出现合并症和预后密切相关。

Objective：To evaluate the clinical value of plasma type B brain natriuretic peptide （BNP） levels in patients with decompensated liver cirrhosis. Methods：One hundred patients with hepatitis B cirrhosis treated in our hospital from January 2012 to April 2017 were collected ,and 100 healthy subjects were selected as control. The plasma BNP level, liver function and MELD score between the two group were observed. At the same time, the difference were compared on Complication , BNP levels, liver function , MELD scores between 1 year survivors and deaths in decompensated liver cirrhosis patients. Results：The levels of plasma BNP, ALT and AST in patients with decompen- sated cirrhosis were higher than those in the control group （t = 187. 630,59. 391,43.130, P 〈 0.001 ） ; The levels of BNP, ALT and AST were higher in the combined ascites group,the combined renal damage group and the death group （P 〈 0. 001 ） ; The MELD score in patients with decompensated liver cirrhosis was significantly higher than that in the control group （ t = 52. 904, P 〈 0.001 ） ; The MELD score of the combined ascites group,the combined renal function injury group and the death group was higher （t = 19.071,22. 150, - 19. 163 ,P 〈 0.001 ）. Conclusion： The level of plasma BNP in patients with decompensated cirrhosis of liver is higher, which is closely related to the occurrence of comorbidity and prognosis.