摘要
目的探讨血浆脑钠肽(BNP)联合心肌综合指数(Tei)评价病毒性肝炎肝硬化患者心功能的价值。方法选取河北北方学院附属第一医院消化内科2014年12月~2016年12月收治的80例病毒性肝炎肝硬化患者,根据Child-Pugh肝功能分级标准分为代偿期组(Child A组30例)、失代偿期组(Child B组25例和Child C组25例),另选取健康者25名作为对照组。采用酶联免疫分析(ELISA)法检测各组的血浆BNP水平,并行超声Tei指数检测。结果 Child B和Child C组血浆BNP水平明显高于Child A组和对照组,Child C组血浆BNP水平明显高于Child B组,差异均有统计学意义(P<0.05);Child B和Child C组左心室的Tei指数和IRT/ET值均明显高于Child A组和对照组,Child C组Tei指数和IRT/ET明显高于Child B组,差异均有统计学意义(P<0.05);而各组右心室Tei指数和IRT/ET值比较差异无统计学意义(P>0.05);血浆BNP和左心室Tei指数在诊断和监测病毒性肝炎肝硬化患者心功能方面具有一致性(r=0.655,P<0.01);多元回归分析显示:左心室Tei指数为血浆BNP的独立危险因素(P<0.01)。结论血浆BNP联合Tei指数能准确评估病毒性肝炎肝硬化患者心功能的变化,为临床治疗和监测提供科学参考。
Objective To investigate the value of brain natriuretic peptide（BNP） combination with Tei index in evaluating the cardiac function of patients with viral hepatitis cirrhosis. Methods Eighty patients with viral hepatitis cirrhosis treated in Department of Gastroenterology, the First Affiliated Hospital of Hebei North University from December 2014 to December 2016 were selected and divided into compensatory stage group（Child A group 30 cases） and non compensatory stage（Child B group 25 cases and Child C group 25 cases） according into Child-Pugh liver function grading standard. Another 20 healthy volunteers were selected as the healthy control group. The plasma BNP level was detected by ELISA method and Tei index was detected by colour doppler imaging. Results The plasma BNP level in the Child B and the Child C group was higher than that in the Child A group and the control group; the plasma BNP level in the Child C group was higher than that in the control group, and there was significant difference（P〈0.05）. The Tei index of left ventricle and IRT/ET value in the Child B and the Child C group were higher than those in the Child A group and the control group. The Tei index of left ventricle and IRT/ET value in the Child C group were higher than those in the control group, and there were also significant differences（P〈0.05）. While there was no difference in Tei index and IRT/ET value of right ventricle in all the groups（P〉0.05）. The plasma BNP and Tei index were consistent in assessing cardiac function in patients with viral hepatitis cirrhosis（r = 0.655, P〈0.01）. Multiple stepwise regression analysis showed that the Tei index of left ventricle was independent risk factor of plasma BNP（P〈0.01）. Conclusion The plasma BNP combination with Tei index could accurately assess the changes of cardiac function in patients with viral hepatitis cirrhosis and provide a scientific reference for clinical treatment and monitoring.
作者
王立坤
张素梅
武雪亮
杨婕琳
杨瑞敏
韩朝
王义成
WANG Likun;ZHANG Sumei;WU Xueliang;YANG Jielin;YANG Ruimin;HAN Chao;WANG Yicheng(Department of Ultrasound,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Ultrasound,Xuanhua District Hospital in Zhangjiakou City,Hebei Province,Zhangjiakou 075000,China;Vascular Surgery Department,the First Affiliated Hospital of Hebei North University,Hebei Province,Zhangjiakou 075000,China;Department of Gastroenterology,the First Affiliated Hospital of Hebei North University,Hehei Province,Zhangjiakou 075000,China)
出处
《中国医药导报》
CAS
2018年第25期127-131,共5页
China Medical Herald
基金
河北省张家口市科技局指令性计划(1621084D)
