肺炎并心力衰竭患儿血浆尾加压素Ⅱ变化的意义  

Change of Plasma Urotensin Ⅱ Level in Children with Pneumonia Complicated with Congestive Heart Failure and Its Clinical Significance

作　　者：颜萍[1] 樊青[1] 张晓静[1] 韩秀珍[2] 巩玲[1] 

机构地区：[1]济南市妇幼保健院儿科,济南250001 [2]山东大学山东省立医院儿科,济南250021

出　　处：《实用儿科临床杂志》2009年第6期446-448,共3页Journal of Applied Clinical Pediatrics

基　　金：济南市卫生局科技项目资助[济卫科外发(2006)34号];济南市科学技术发展计划项目[济科计(2006)9号]

摘　　要：目的探讨肺炎并心力衰竭(心衰)患儿血浆尾加压素Ⅱ(UⅡ)变化的意义。方法选择肺炎并心衰患儿30例(肺炎并心衰组)。男16例,女14例;年龄2个月～2岁。普通肺炎患儿30例(普通肺炎组)。男女各15例;年龄2个月～3岁。同期随机选择体检健康儿童30例(健康对照组)。男18例,女12例;年龄6个月～4岁。3组儿童均空腹抽静脉血3 mL,放射免疫法检测各组儿童血浆UⅡ水平,ELISA法检测其心肌肌钙蛋白I(cTnI),免疫抑制法测定其CK-MB。肺炎并心衰组20例患儿治疗后复测UⅡ、cTnI及CK-MB,超声心动仪测定患儿左室射血分数(EF)、左室短轴缩短百分率(FS)。应用SAS8.2软件进行统计学分析。结果肺炎并心衰组与普通肺炎组及健康对照组比较,UⅡ、cTnI及CK-MB显著升高(F=64.42,178.55,99.67 Pa<0.05);EF、FS显著下降(F=24.83,54.42 Pa<0.05)。肺炎并心衰组患儿治疗后血浆UⅡ、cTnI及CK-MB水平与治疗前比较均显著下降(t=7.27,12.84,7.21 Pa<0.01),EF、FS显著升高(t=6.24,8.59 Pa<0.01)。肺炎并心衰组治疗前血浆UⅡ与EF、FS为呈显著负相关(r=-0.761,-0.732 Pa<0.01),与cTnI、CK-MB为呈显著正相关(r=0.861,0.862 Pa<0.01)。结论UⅡ参与肺炎并心衰的病理生理过程,血浆UⅡ水平可反映心功能程度,肺炎并心衰时血浆UⅡ的升高与心肌损害有关。Objective To explore the change of plasma urotensin Ⅱ（ U Ⅱ ） level in children with pneumonia complicated with congestive heart failure and its clinical implications. Methods Thirty children with pneumonia complicated with heart failure aged from 2 months to 2 years old were selected with 16 male and 14 female（ heart failure group）. Thirty children with ordinary pneumonia aged from 2 months to 3 years old were also sampled with 15 male and 15 female（ ordinary pneumonia group）. Thirty healthy children aged from 6 months to 4 years old were randomly selected with 18 male and 12 female（ healthy control group）. The peripheral bloods of 3 mL of all children in 3 groups were taken. The plasma U Ⅱ levels were determined by radioimmunoassay, the cardiac troponin Ⅰ （cTnⅠ） were measured by enzyme linked immunosorbent assay ,the cardiac enzyme of creoinin kinase（ CK - MB） were determined by immunosuppression. The levels of U Ⅱ ,cTnⅠ and CK - MB were determined again in 20 patients with pneumonia complicated with heart failure after treatment. Ejection fraction （EF）, fractional shortening （FS） were measured by Doppler uhrasonography. SAS 8.2 software was used to analyze the data. Results The levels of U Ⅱ , eTnI and CK - MB in heart failure group the increased significantly compared with those of healthy control group and ordinary pneumonia group （F=64.42,178.55,99.67 P, 〈0.05） ,while their EF,FS decreased significantly（F =24. 83,54.42 Pa 〈0.05）. After treatment,the levels of U Ⅱ , cTnⅠ and CK - MB in heart failure group decreased significantly compared with those of pre - treatment（ t = 7.27,12. 84,7.21 P 〈0.01 ） ,and EF,FS increased significantly （t =6.24,8.59 Pa 〈0.01 ）. Before treatment,U Ⅱ correlated negatively with EF,FS（r = - 0. 761, - 0. 732 Pa 〈 0.01 ）, U Ⅱcorrelated positively with cTnI and CK - MB （ r = 0. 861,0. 862 Pa 〈 0.01 ）. Conclusions U Ⅱ is involved in the pathophysiology of pneumonia complicated with heart fail

关 键 词：肺炎 心力衰竭 尾加压素Ⅱ 心肌肌钙蛋白 心功能 

分 类 号：R725.6[医药卫生—儿科]