【摘要】 目的探讨慢性充血性心力衰竭(chronic congestive heart failure,CHF)患者肝功能指标与N端脑利钠肽前体水平(N-terminal pro-brain natriuretic peptide,NT-proBNP)变化的相关性及临床意义。方法测定242例慢性心力衰竭患者(心衰组)和68例健康对照者(对照组)肝功能、血清NT-proBNP水平和左室射血分数(left ventricular ejection fraction,LVEF),心力衰竭患者心功能按NYHA心功能分级分为心衰Ⅱ级、Ⅲ/Ⅳ级组,分析肝功能、NT-proBNP水平与不同心衰程度的关系。结果心衰组总胆红素(total bilirubin,TBil)、直接胆红素(direct bililubin,DBil)、间接胆红素(indirect bilirubin,IBIL)、NT-proBNP水平明显高于对照组,心衰III/IV组TBil、DBil、IBil、NT-proBNP水平较II级组明显升高,在心衰组,TBil、DBil、IBil与NT-proBNP和NYHA心功能分级成正相关,与LVEF值成负相关。心衰组治疗后,TBil、DBil、IBil与NT-proBNP较治疗前明显降低。结论血清胆红素水平随心力衰竭严重程度的增加而升高,并与NT-proBNP水平和心功能状态相关,对慢性心力衰竭的诊断和病情判断有一定的临床价值。更多还原

【Abstract】 【Objective】 To evaluate the correlation of N-terminal pro-brain natriuretic peptide(NT-proBNP) with liver function and clinical features in patients with chronic congestive heart failure(CHF).【Methods】 Clinical data of 242 cases of CHF and 68 cases of healthy volunteers were included.Serum NT-proBNP,biochemical parameters of liver function,and left ventricular ejection fraction(LVEF) were recorded on days 0 after hospital admission.All CHF patients were graded from Grade II to Grade III/IV group according to NYHA grading criteria.Relationship among the changes of liver function,NT-proBNP levels and grades of CHF was analyzed.【Results】 Total bilirubin(TBil),direct bililubin(DBil),indirect bilirubin(IBil) and NT-proBNP levels were significantly increased in patients with CHF compared to the healthy volunteers,while the serum parameters increased remarkably when the grade of CHF changed from grade II to grade III/IV.TBil,DBil,IBil were positively correlated with NT-proBNP levels and NYHA,while inversely correlated with LVEF in patients with CHF.【Conclusion】 Serum bilirubin increased with the up-grade of CHF.The study revealed significant positive correlation between NT-proBNP and cardiac function with serum bilirubin levels in patients with CHF.The correlation of NT-proBNP with serum bilirubin would play a role in the grading determination and prognosis assessment in patients with CHF.更多还原