动脉导管未闭患儿介入封堵前后心率变异性及血浆肾上腺髓质素、B型利钠肽的变化  

Heart rate variability, adrenomedullin and B-type natriuretic peptide before and after transcatheter closure in children with patent ductus arteriosus

作　　者：吴蓉洲[1] 荣星[1] 任跃[1] 何旭香[1] 项如莲[1] 

机构地区：[1]温州医学院附属第二医院附属育英儿童医院儿童心血管科,325000

出　　处：《中华心血管病杂志》2010年第4期334-336,共3页Chinese Journal of Cardiology

摘　　要：目的探讨动脉导管未闭（PDA）患儿介入封堵术前后心率变异性及血浆肾上腺髓质素、B型利钠肽（BNP）水平的变化及临床意义。方法选择55例PDA患儿作为PDA组，在介入封堵术前3d及术后3d、3个月分别检测心率变异性频域（总频谱、极低频功率、低频功率、高频功率、低频功率／高频功率）结果及血浆肾上腺髓质素、BNP水平。另选60名健康儿童作为对照组。结果（1）与对照组比较，PDA组术前心率变异性频域总频谱、极低频功率、高频功率均较低，而低频功率／高频功率及血浆肾上腺髓质素、BNP水平均较高（均P〈0．01）。（2）介入封堵术后3d及3个月，血浆。肾上腺髓质素水平均较术前明显降低（均P〈0．01），而与对照组比较差异无统计学意义。心率变异性及血浆BNP水平术后3d与术前差异无统计学意义。与术前比较，术后3个月心率变异性频域总频谱、极低频功率、高频功率均明显升高（P〈0．01或P〈0．05），而低频功率／高频功率及血浆BNP水平明显降低（均P〈0．01）。结论心率变异性及血浆肾上腺髓质素、BNP水平在PDA介入封堵术后均改善，可作为了解PDA介入封堵术后心脏自主神经及内分泌功能恢复的随访指标。Objective To observe the changes of heart rate variability （HRV）, adrenomedullin （ADM） and B-type natriuretic peptide（BNP） before and after transcatheter closure in children with patent ductus arteriosus. Methods HRV spectral values （TF, VLF, LF, HF, LF/HF） were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent duetus arteriosus（ Group PDA, n = 55） before and 3^rd day, 3^rd month after transcatheter closure therapy, and in 60 normal children （Group C）. Results （ 1 ） Compared with Group C, the HRV spectral values （ TF, VLF, HF）were significantly lower （all P 〈 0. 01 ）, LF/HF and the concentrations of plasma ADM, BNP were significantly higher in patients with PDA before transcatheter closure （ all P 〈 0.01 ）. （ 2 ） Compared with the values before transcatheter closure values, plasma ADM were significantly reduced at 3^rd day and 3^rd month after transcatheter closure （ P 〈 0.01 ）, the HRV spectral values （ TF, VLF, HF） were significantly increased while LF/HF and plasma BNP were significantly decreased at 3^rd month after transcatheter closure （P 〈 0. 01 or P 〈 0. 05 ）. Conclusions HRV and plasma ADM, BNP improved significantly post transcatheter closure in children with patent ductus arteriosus.

关 键 词：动脉导管未闭 心率 肾上腺髓质素 利钠肽 脑 

分 类 号：R725.4[医药卫生—儿科]