先天性心脏病介入封堵术前后血清心肌型脂肪酸结合蛋白水平的变化及其影响因素分析  

Changes of serum heart-type fatty acid binding protein level after interventional occlusion for congenital heart diseases and analysis of its influence factors

作　　者：张燕[1] 李靖[1] 李莉[1] 关怀敏[1] 

机构地区：[1]河南省胸科医院心内科,郑州450003

出　　处：《郑州大学学报（医学版）》2009年第4期830-832,共3页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:观察先天性心脏病介入封堵术前后血清心肌型脂肪酸结合蛋白(H-FABP)水平的动态变化并分析其影响因素。方法:选择室间隔缺损(VSD)患儿42例、动脉导管未闭(PDA)患儿36例、房间隔缺损(ASD)患儿30例,于介入治疗术前、术后15min、4h、24h测量血清H-FABP水平。采用多元线性回归分析影响血清H-FABP水平的相关因素。结果:各组术后15min、4hH-FABP水平较术前均升高(F时间=55.312,F组间=62.161,P均<0.01),高峰均出现在术后15min;多重线性回归分析显示病理类型、年龄、手术时间、封堵器释放次数是影响术后血清H-FABP水平的主要因素(β分别为0.666,-0.460,0.589,0.483,P均<0.05)。结论:先天性心脏病介入封堵术可引起可逆性的心肌微损伤,血清H-FABP水平升高程度与病理类型、年龄、手术时间、封堵器释放次数有关。Aim： To investigate the dynamics of seruin heart-type fatty acid binding protein （H-FABP） level after interventional occlusion for congenital heart diseases （CHD） and to analyze its influence factors. Methods：A total of 108 patients, including 42 patients of ventricular septal defect （VSD） , 36 patients with patent ductus arteriosus （PDA） , and 30 patients with atrial septal defect （ASD） , were measured for the levels of H-FABP at baseline and 15 min, 4 h, 24 h after occlusion,respectively. And the influence factors of serum H-FABP level were analyzed by using muhiple regression analysis. Results ： The serum H-FABP level was significantly higher at 15 rain, 4 h after occulusion compared with those of pretreatment respectively（ Ftime = 55.312, Fgroup= 62. 161, P 〈 0.01 ） , and the peak level of H-FABP occurred at 15 min. Multiple-linear regression model revealed the serum H-FABP peak level was correlated with pathological type,age, total time of intervention application, and times of occluders releasing,β was 0. 666, - 0. 460,0. 589, and 0. 483 individually （ P 〈 0.05 ）. Conclusion ： Interventional occlusion in the patients with CHD might result in reversible, minor myocardial damage. Pathological types,age, total time of intervention application,and times of oecluders releasing are influence factors for serum H-FABP peak level in patients with CHD.

关 键 词：心脏缺损 先天性 心肌型脂肪酸结合蛋白 封堵术 影响因素 

分 类 号：R654.2[医药卫生—外科学]