| Objective:To investigate the cardiac and inflammatory markers in patients with cirrhosis,through electrocardiogram and echocardiography and to understand the cardiac function in patients with cirrhosis, in order to look for a better diagnosis method of cirrhotic cardiomyopathy(Cirrhotic cardiomyopathy, CCM). Furthermore, the essay will evaluate the correlation between related indexes and disease progression by“follow-up” method.Methods:86 patients with cirrhosis(cirrhosis group) and 23 patients with hepatitis(control group) were recruited from the First Hospital of Jilin University. Cirrhosis group was divided into A, B, C groups according to Child-Pugh score. All patients need to check plasma pro-BNP, serum c Tn I and CRP levels. Electrocardiogram and echocardiography were carried out at the same time. After 6 months follow-up, the same blood and electrocardiogram indicators were checked. To compare the differences of plasma pro-BNP, serum c Tn I and CRP levels, QTc and echocardiography parameters between the two groups. Furthermore, analyze the correlation of pro-BNP,c Tn I, CRP, QTc and the changes of cardiac structure and function and liver function(Child-Pugh score, MELD score) in patients with cirrhosis.And after 6 months follow-up, analyze the correlation between the changes of each index and liver function.Results:Comparison between cirrhosis group and control group: blood index, medians of CRP were 3.30(3.30, 6.72) mg/l and 3.30(3.30, 3.54) mg/l; medians of pro-BNP were 100.65(54.45,173.75) pg/ml and 34.90(28.40, 83.50) pg/ml; medians of c Tn I were 0.014(0.012, 0.019)ng/ml and 0.017(0.013,0.022)ng/ml; except CRP level, the rest two indicators of differences among the two groups were statistically significant(P<0.05); in the electrocardiogram testing, the medians of QTc were 416(404.5,430.0)and 435(421.5,454.3)ms and the difference between the two groups was statistical significant(P<0.05); in the echocardiography testing, among the six indexes, only the LA diameter and E/A between the two groups had significant difference, with statistical significance(P<0.05) and there was no significantly different in LVEF,deceleration time and IVRT. Comparison between each grade in the cirrhosis group and the control group: in blood and the electrocardiogram, BNP and QTc at all grades had statistical differences; CRP and c Tn I only in Grade C were significantly increased,with statistical significance. In the echocardiography testing, LA diameter increases gradually at all grades and the differences were statistically significant(P=0.003); E/A decreases gradually, and the difference is statistically significant(P<0.001); LVEF between Grade B and control group have significant differences, but there was no significant difference between Grade A, C and the control group. In the Correlation analysis, there was a significant positive correlation between plasma pro-BNP, QTc,LAD and CTP score, MELD score, and there was a significant negative correlation between E/A and CTP score, MELD score. Cirrhosis group and control group showed no patients with systolic dysfunction; the incidence of diastolic dysfunction in the cirrhosis group was higher than in the control group(46.3%vs4.3%); abnormal rate of QTc: control group 1/23(4.3%), cirrhosis group A, B and C grade respectively was(27%, 36% and 70%). After 6 months follow-up, the correlation between the changes of CRP and BNP and c Tn I, QTc within 6 months and liver score changes were(0.25, 0.58,-0.07, 0.21), in which pro-BNP and liver function changes show significant positive correlation and had statistical significance(P=0.005), the other three have no statistical significance(P>0.05).Conclusions:Patients with cirrhosis have myocardial damage, which is shown as diastolic function damage in the early stage and has a positive correlation with the severity of cirrhosis. Plasma pro-BNP can reflect the condition of cirrhotic cardiomyopathy sensitively; neither CRP nor c Tn I levels can reflect the condition of cirrhotic cardiomyopathy accurately. |
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