摘要
目的探讨肝硬化患者血浆B型利钠肽水平与病情严重程度以及患者预后之间的关系。方法采集86例肝硬化患者(实验组)和同期健康体检者86人(对照组)的基本信息,包括血浆BNP、白蛋白、肾功能、凝血功能以及是否存在消化道出血和肝硬化腹水等指标,探讨血浆BNP与这些指标之间的关系;患者出院后随访6个月,进行生存曲线分析。结果实验组患者血浆BNP水平高于对照组,实验组中Child-pugh C级>B级>A级,差异均有统计学意义(P<0.05);实验组合并消化道出血、粪便隐血、贫血、腹水、肾功能异常情况的患者血浆BNP水平高于不合并上述症状者,差异均有统计学意义(P<0.05);而不同年龄、性别、体重、病因患者间血浆BNP水平差异无统计学意义(P>0.05);实验组患者血浆BNP水平与肌酐、总胆红素、凝血酶原时间呈明显正相关,与白蛋白水平呈明显负相关;均P<0.05。出院后半年,BNP>182.5 pg/mL者生存率低于BNP≤182.5 pg/mL者,差异有统计学意义(P<0.05)。结论肝硬化患者血浆BNP水平与年龄、性别、体重、病因等基本情况无关,可反映肝功能水平,并受消化道出血、贫血、腹水、肾功能等因素影响,对评估患者预后具有一定参考价值。
Objective To understand the correlation of plasma B-type natriuretic peptide levels to the degree of liver cirrhosis and prognosis.Method Firstly,86 patients of liver cirrhosis were chosen as the experimental group and 86 healthy people were selected as the control group.The BNP,albumin,renal function,coagulation function,gastronintestinal bleeding and ascites were evaluated and the correlations of BNP level with those indices were analyzed.The Kaplan-Meier analysis was used to evaluate the survival curve within the 6 months after the patients were discharged.Findings The BNP levels in the experimental group was greatly higher than that in the control group（P〈0.001）.The BNP levels in the patients with Child-pugh C score was significantly higher than that in the patients with Child-pugh A or B score.In the patients with gastrointestinal bleeding,anemia,ascites and renal dysfunction,the BNP level was higher than those without the above symptoms.There was no obviously difference in plasma levels of BNP between different ages,genders,weights and pathogenies（P〈0.05）.The level of plasma BNP in the experimental group was positively correlated with CR,TBIL and PT（P〈0.05） while it was negatively correlated with ALB（P〈0.05）.The patients with BNP over 182.5 pg/ml had significantly lower survival rate than those who were less than 182.5 pg/ml within 6 months after hospital discharge（P〈0.05）.Conclusion Age,gender,weight and pathogeny have no significant correlations with plasma BNP level in the patients with liver cirrhosis.The BNP level affected by gastrointestinal bleeding,anemia,ascites and renal function can reflect liver function and can provide clues for evaluating prognosis.
出处
《健康研究》
CAS
2017年第6期612-615,621,共5页
Health Research
关键词
B型利钠肽
肝硬化
消化道出血
腹水
预后
B-type brainnatriuretic peptide
liver cirrhosis
gastronintestinal bleeding
ascites
prognosis
