先天性心脏病患儿血清儿茶酚胺 醛固酮测定临床意义研究  

The level of the serum CA,ALD and cardiac function in children with congenital heart disease

作　　者：邢淑华[1] 张宏艳[1] 林书祥[1] 徐兆峰[1] 

机构地区：[1]天津市儿童医院心内科,天津300074

出　　处：《中国实用儿科杂志》2010年第10期787-790,共4页Chinese Journal of Practical Pediatrics

摘　　要：目的研究小儿左向右分流型先天性心脏病(CHD)血清儿茶酚胺(CA)[肾上腺素(E)、去甲肾上腺素(NE)、多巴胺(DA)]和醛固酮(ALD)的变化,分析其与心功能、容量负荷、肺动脉压力及心肌重塑的相关性。方法 2007年10月至2008年10月天津市儿童医院心脏科住院经彩色多普勒超声心动图检查确诊为左向右分流性CHD患儿53例,对照组20例,检测血清CA、ALD。采用实时三维超声心动图检测心脏房室腔径及心功能指标。结果 (1)CHD组血清NE、ALD高于对照组(P<0.01)。(2)心衰组、大分流组、肺动脉高压组血清CA、ALD高于无心衰组、小分流组、无肺动脉高压组(P<0.01)。(3)心衰组患儿左室舒张末期内径指数、左室舒张末期容积指数、左室质量指数均高于无心衰组(P<0.01)。(4)血清CA与左房内径指数、左室舒张末期内径指数、左室舒张末期容积指数呈正相关(P<0.01)。结论血清CA、ALD可作为早期诊断心力衰竭及肺动脉高压的血清学指标之一,CA与心肌重塑密切相关。Objective To investigate the level of serum catecholamine （CA） Lincluding epinephrine （E）, norepinephrine （ NE ）, dopamine （ DA ） ] and aldosterone （ ALD ） in children with left to right shunt congenital heart disease （ CHD ）, and analyze the correlation between the serum CA, ALD and cardiac function, ventricular volume load, pulmonary artery pressure and myocardial remodeling. Method Totally 53 cases of left to right shunt CHD and 20 cases of control group were induded in the study. We measured the content of serum CA and ALD in the control group and CHD group. We applied real-time three- dimensional echocardiogram to measure the left atrium diameter （LAD） , left ventricular end diastolic inner diameter （LVEDD） , and cardiac function. Result （ 1 ） The level of serum NE and ALD in CHD group was higher than the control group （P 〈 0.01 ）. （2）The level of serum CA and ALD was higher in heart failure group, large shunt group and pulmonary artery hypertension group than in non-heart failure group, small shunt group and non-pulmonary artery hypertension group （P 〈 0.01）. （3）The left vcntricular end diastolic inner diameter index （LVEDDI）, left ventricular end diastolic volume index （LVEDVI） and left ventricular mass index of heart failure group were larger than those of non-heart failure group（P 〈 0.01 ）. （4）There was positive correlation between the serum level of CA and left atrial diameter index （P 〈 0.01 ） and LVEDDI （P 〈 0.01）, LVEDVI （P 〈 0.01 ）. Conclusion The serum CA and ALD may be regarded as an objective parameter in the early diagnosis of heart failure and pulmonary artery hypertension. There is a positive correlation between the serum CA and myocardial remodeling.

关 键 词：先天性心脏病 儿茶酚胺 醛固酮 心肌重塑 小儿 

分 类 号：R72[医药卫生—儿科]