血浆心肌营养素-1在心力衰竭患儿中的变化及意义  

Changes and significance of plasma cardiotrophin-1 in children with heart failure

作　　者：殷国田[1] 何益群[2] 解娜[1] 张峥[1] 杨萌[1] 魏明旭[2] 任明芬[2] 

机构地区：[1]新乡医学院第三附属医院心内科,453003 [2]新乡医学院第二附属医院心内科

出　　处：《中华实用儿科临床杂志》2013年第13期1000-1002,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：河南省教育厅科技攻关项目（2007320028）

摘　　要：目的 探讨血浆心肌营养素-1（CT-1）在心力衰竭患儿中的变化及意义。方法 选择新乡医学院第三附属医院及第二附属医院住院的心力衰竭患儿40例（NYHAⅡ级14例，Ⅲ级16例，Ⅳ级10例）为观察组，20例健康体检儿童为健康对照组。采用ELISA法测定其血浆 CT-1水平，锐普荧光干式定量分析仪测定N 端脑钠肽（NT-proBNP）水平，同时采用GE Vivid7彩色多普勒超声心动图测定左心室射血分数（LVEF），改良 ROSS评分评定心功能。比较2组血浆 CT-1、NT-proBNP及 LVEF的差异，并分析不同程度心力衰竭患儿血浆 CT-1水平与 NT-pro BNP、LVEF的相关性。结果 观察组血浆 CT-1、NT-pro BNP水平明显高于健康对照组（P 〈0.01），且随着心力衰竭程度加重二者水平逐渐增高。不同心功能级别之间比较显示，各组 CT-1水平差异均具有统计学意义（F =55.5，P 〈0.01）。Pearson相关分析显示，观察组血浆CT-1与NT-proBNP、改良ROSS 评分均呈正相关（r=0.787、0.848，P均〈0.01），与LVEF呈负相关（r= -0.66，P 〈0.01）。结论 心力衰竭患儿血浆CT-1水平明显升高，且与NT-proBNP和LVEF有较好相关性。CT-1是反映患儿心力衰竭病情严重程度的可靠指标，联合检测NT-proBNP可能有助于提高患儿心力衰竭的正确诊断率。Objective To explore the changes and significance of plasma cardiotrophin-1 （ CT-1 ） in children with heart failure. Methods Forty children with heart failure （ NYHA Ⅱ, n = 14 ; NYHA Ⅲ, n = 16 ; NYHA Ⅳ, n = 10 ） were chosen as observation group, and 20 healthy children without heart failure were taken as healthy control group. Plasma CT-1 was measured by a double antibody sandwich enzyme-linked immunosorbent assay （ELISA）. N terminal probrain natriuretic peptide（ NT-pro BNP） concentration was tested by Pu Rui fluorescent dry quantitative analyzer. Left ventricular ejection fraction（LVEF） was evaluated by GE Vivid 7 doppler echocardiography and cardiac function as- sessed by modified ROSS score. Plasma CT-1 level, NT-pro BNP and LVEF were compared between the 2 groups. The correlation of plasma CT-1 level with NT-pro BNP and LVEF were analyzed in patients with different degrees of heart failure. Results Plasma levels of CT-1 and NT-pro BNP were significantly higher in children with heart failure than those in healthy control group （P 〈 0.01 ） , and with progression of heart failure, the levels of CT-I and NT-pro BNP pro-gressively increased in heart failure children. Plasma CT-1 level in different NYHA had statistical significance （ F = 55.5 ,P 〈0. 01 ）. Plasma CT-1 level was positive correlated with NT-pro BNP and modified ROSS score（ r = 0. 787, 0. 848, all P 〈 0. O1 ）, and negative associated with LVEF （ r = - 0. 66, P 〈 0.01 ）, respectively, in heart failure chil-dren. Conclusions Plasma CT-1 level is significantly elevated in heart failure children. There are good correlation a-mong CT-1, NT-pro BNP and LVEF. Plasma CT-1 is a reliable marker of reflecting the severity of heart failure, com- bined with NT-pro BNP detection helps to improve the diagnostic accuracy of heart failure in children.

关 键 词：心肌营养素-1 N端脑钠肽 心力衰竭 儿童 

分 类 号：R725.4[医药卫生—儿科]