血清 NT-proCNP 浓度在慢性肝脏疾病患者中升高，并与肝硬化的并发症和不良预后相关。
Serum NT-proCNP concentrations are elevated in patients with chronic liver diseases and associated with complications and unfavorable prognosis of cirrhosis.
机构信息
Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
出版信息
Clin Biochem. 2012 Apr;45(6):429-35. doi: 10.1016/j.clinbiochem.2012.01.009. Epub 2012 Jan 18.
OBJECTIVES
C-type natriuretic peptide (CNP) might be an important regulator of vasodilatation, fluid and sodium balance in liver cirrhosis. We aimed at assessing its regulation and prognostic relevance in liver disease patients.
DESIGN AND METHODS
We analyzed NT-proCNP serum levels in 193 patients with chronic liver diseases and 43 healthy controls.
RESULTS
Serum NT-proCNP concentrations were significantly elevated in liver disease patients compared to healthy controls, with highest levels in established hepatic cirrhosis, independent of disease etiology. NT-proCNP was associated with complications of liver diseases and portal hypertension, namely ascites, esophageal varices and hepatic encephalopathy. Circulating NT-proCNP correlated inversely with renal function. Importantly, elevated NT-proCNP levels were identified as a predictor of mortality or necessity for transplantation. NT-proCNP levels >2 pmol/L indicated adverse prognosis (sensitivity 66.7%, specificity 72.8%, RR 5.4 [95%-CI 2.6-11.2]).
CONCLUSIONS
Serum NT-proCNP is elevated in advanced liver diseases and has prognostic value in cirrhotic patients.
目的
C 型利钠肽（CNP）可能是肝硬化中血管舒张、液体和钠平衡的重要调节剂。我们旨在评估其在肝病患者中的调节作用和预后相关性。
设计和方法
我们分析了 193 例慢性肝病患者和 43 例健康对照者的 NT-proCNP 血清水平。
结果
与健康对照组相比，肝病患者的血清 NT-proCNP 浓度明显升高，在已确诊的肝硬化中最高，且与疾病病因无关。NT-proCNP 与肝病和门静脉高压的并发症有关，即腹水、食管静脉曲张和肝性脑病。循环中的 NT-proCNP 与肾功能呈负相关。重要的是，升高的 NT-proCNP 水平被确定为死亡或需要移植的预测因子。NT-proCNP 水平>2 pmol/L 表明预后不良（敏感性 66.7%，特异性 72.8%，RR 5.4 [95%-CI 2.6-11.2]）。
结论
血清 NT-proCNP 在晚期肝病中升高，对肝硬化患者具有预后价值。
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