超声心动图联合血浆NT-proBNP检测对酒精依赖性肝硬化患者心功能不全的诊断价值

摘要/Abstract

摘要： 目的研究超声心动图联合血浆N末端B型利钠肽原(NT-proBNP)检测对酒精依赖性肝硬化患者心功能不全(CIS)的诊断价值。方法选取2020年5月至2022年5月阜阳市第三人民医院酒精依赖性肝硬化患者79例,其中CIS组17例,非CIS组62例,均行超声心动图检查,检测NT-proBNP。对比两组临床资料、Tei指数及NT-proBNP,分析CIS发生的影响因素及Tei指数联合NT-proBNP对CIS的诊断价值。结果 CIS组肝硬化病程(3.12±0.40)年、肝硬化分级C级10/17例、AST(79.23±8.92)U/L、ALT(68.52±9.21)U/L,高于非CIS组(2.44±0.35)年、16.13%(10/62)、(58.25±6.23)U/L、(51.28±7.10)U/L(P<0.05)。CIS组Tei指数(0.59±0.16)、血浆NT-proBNP水平(251.36±39.47)pg/mL,高于非CIS组(0.48±0.11)、(178.25±30.19)pg/mL(P<0.05)。经logistic回归分析,肝硬化病程、肝硬化分级、Tei指数、血浆NT-proBNP水平均为CIS发生的影响因素(P<0.05);经受试者工作特征曲线下面积(AUC)分析,Tei指数、NT-proBNP诊断酒精依赖性肝硬化患者CIS发生的Cut-off值为0.54、227.42 U/mL,AUC为0.873、0.750,Tei指数联合NT-proBNP预测的AUC为0.932。结论超声心动图联合血浆NT-proBNP对酒精依赖性肝硬化患者发生CIS具有较高诊断价值。

关键词: 超声心动图, N末端B型利钠肽原, 酒精依赖性肝硬化, 心功能不全

Abstract: Objective To investigate the diagnostic value of echocardiography combined with plasma N-terminal pro B-type natriuretic peptide (NT proBNP) in patients with alcohol dependent-cirrhosis with cardiac insufficiency (CIS). Methods From May 2020 to May 2022, 79 patients with alcohol dependent-cirrhosis in the Ultrasound Department of Fuyang Third People's Hospital were enrolled. They were divided into CIS group and non-CIS group. All patients received echocardiography and the plasma NT proBNP level test. The clinical data, Tei index and plasma NT proBNP level between the two groups were compared to analyze the influencing factors of CIS. The diagnostic value of Tei index combined with plasma NT proBNP level for CIS were further evaluated. Results In CIS group, the duration of cirrhosis was (3.12 ± 0.40) years, the proportion of cirrhosis grade C was 58.82%, AST was (79.23 ± 8.92) U/L, ALT was (68.52 ± 9.21) U/L. It was higher than those in non-CIS group, with duration of cirrhosis as (2.44 ± 0.35) years, the proportion of 16.13%, ALT of (58.25 ± 6.23) U/L, AST of (51.28 ± 7.10) U/L (P<0.05). Tei index (0.59 ± 0.16) and plasma NT proBNP level (251.36 ± 39.47) pg/mL in CIS group were also higher than those in non-CIS group (0.48 ± 0.11) and (178.25 ± 30.19) pg/ml (P<0.05). Logistic regression analysis showed that the course of liver cirrhosis, liver cirrhosis grade, Tei index, and plasma NT proBNP level were the risk factors for CIS (P<0.05). The Receiver operating characteristic curve (ROC) analysis showed that the cut-off values of patients with alcohol dependent cirrhosis diagnosed by Tei index and plasma NT proBNP level were 0.54 and 227.42U/ml, AUC values were 0.873 and 0.750. And the AUC value predicted by Tei index combined with plasma NT proBNP level is 0.932. Conclusion Echocardiography combined with plasma NT proBNP showed a high diagnostic value for CIS in patients with alcohol dependent cirrhosis.

Key words: Echocardiography, N-terminal B-type natriuretic peptide, Alcohol dependent cirrhosis, Cardiac insufficiency

薛雪, 高勤, 赵晟. 超声心动图联合血浆NT-proBNP检测对酒精依赖性肝硬化患者心功能不全的诊断价值[J]. 肝脏, 2023, 28(7): 767-771.

XUE Xue, GAO Qin, ZHAO Sheng. Diagnostic value of echocardiography combined with plasma NT proBNP in patients with alcohol dependent cirrhosis with cardiac insufficiency[J]. Chinese Hepatolgy, 2023, 28(7): 767-771.

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