实用肝脏病杂志2024，Vol.27Issue(2)：242-245,4.DOI:10.3969/j.issn.1672-5069.2024.02.021
血清NT-ProBNP和TnI联合心电图检查早期诊断肝硬化性心肌病价值研究
Elevated serum NT-ProBNP and TnI levels occurs before abnormal electrocardiogram manifestations in patients with cirrhotic cardiomyopathy
摘要
Abstract
Objective The aim of this study was to explore serum N-terminal pro-brain natriuretic peptide(NT-ProBNP)and troponin I(TnI)level changes in patients with liver cirrhosis for early diagnosis of cirrhotic cardiomyopathy(CCM).Methods 93 patients with liver cirrhosis and 49 healthy persons at physical examination were enrolled in our hospital between January 2020 and March 2023,and all underwent electrocardiography(EKG).Serum TnI level was detected by chemiluminescence immunoassay and serum NT-ProBNP level was measured by ELISA.The diagnostic performance was evaluated by the area under the receiver operating characteristic curve(AUROC)analysis.Results Out of our series,the CCM was found in 51 cases,including NYHA classⅠ in 18 cases,class Ⅱ in 20 cases and class Ⅲ in 13 cases based on cardiac Doppler ultrasonography;serum NT-ProBNP and TnI levels in patients with CCM were(41.5±7.9)pmol/L and(0.6±0.2)μg/mL,significantly higher than[(28.9±5.2)pmol/L and(0.3±0.1)μg/mL,respectively,P＜0.05]in cirrhotics without CCM or[(8.3±1.6)pmol/L and(0.1±0.1)μg/mL,P＜0.05]in healthy individuals;the abnormal EKG manifestation in patients with CCM accounted for 98.0%,much higher than 71.4%in patients with liver cirrhosis or 2.0%(P＜0.05)in healthy persons;serum NT-ProBNP and TnI levels in patients with CCM class Ⅲ were(48.3±8.5)pmol/L and(0.8±0.2)pmol/L,significantly higher than[(42.1±7.8)pmol/L and(0.6±0.1)pmol/L,P＜0.05]in patients with CCM classⅡor[(35.9±7.9)pmol/L and(0.5±0.1)pmol/L,P＜0.05]in patients with CCM classⅠ;the AUC was 0.923,with the sensitivities of 94.1%and the specificities of 78.6%when serum NT-ProBNP level equal to 40.4 pmol/L and serum TnI level equal to 0.5μg/mL were set as the cut-off-value,and with abnormal EKG combination in predicting CCM,much superior to any of the parameters did alone(P＜0.05).Conclusion The elevated serum NT-ProBNP and TnI levels in patients with decompensated liver cirrhosis might hint the existence of CCM,which occurs early before abnormal EKG manifestations loom.关键词
肝硬化性心肌病/氨基末端B型尿钠肽前体/肌钙蛋白Ⅰ/心电图/诊断Key words
Cirrhotic cardiomyopathy/N-terminal pro-brain natriuretic peptide/Troponin I/Electrocardiogram/Diagnosis引用本文复制引用
朱春芬,任春霖,郭霞..血清NT-ProBNP和TnI联合心电图检查早期诊断肝硬化性心肌病价值研究[J].实用肝脏病杂志,2024,27(2):242-245,4.基金项目
湖北省科技厅重点科技计划项目(编号:2021KJ0210) （编号:2021KJ0210）
