先天性心脏病患者介入治疗前后血浆NT-proBNP和cTnT变化  

Changes of plasma NT-proBNP and cTnT in patients with congenital heart disease underwent interventional therapy

作　　者：张莉[1] 张浩 杨荣 盛燕辉 孙伟[2] 张海锋 孔祥清 

机构地区：[1]南京市中医院心血管病科,江苏省210001 [2]南京医科大学第一附属医院心血管病科

出　　处：《江苏医药》2015年第7期762-764,共3页Jiangsu Medical Journal

基　　金：国家自然科学基金青年基金(30901473)

摘　　要：目的探讨先天性心脏病(CHD)患者介入治疗前后血浆N末端脑钠肽前体(NT-proBNP)和心肌肌钙蛋白T(cTnT)水平的变化。方法检测98例左向右分流型CHD患者介入术前后血浆NT-proBNP及cTnT水平,采用超声心动图测定左室舒张末期内径(LVEDD)和射血分数(EF)。结果介入治疗均获得成功。与术前1d相比,动脉导管未闭(PDA)和室间隔缺损(VSD)患者术后1d和3d血浆NT-proBNP均降低,而房间隔缺损(ASD)患者术后1d增加、术后3d降低(P<0.01)。所有患者术前、术后cTnT无显著变化(P>0.05)。与术前1d相比,PDA和VSD患者术后3d的LVEDD减小、EF增加(P<0.01),而ASD患者LVEDD和EF无显著变化(P>0.05)。结论 CHD患者介入治疗后短期内心功能即有改善,无明显心肌损伤。检测血浆NT-proBNP水平有助于评估CHD患者介入前后的心功能。Objective To observe the changes of plasma N-terminal pro-brain natriuretic peptide（NT-proBNP）and cardiac troponin T（cTnT）in the patients with congenital heart disease（CHD）underwent interventional therapy.Methods Plasma NT-proBNP and cTnT were detected before and after intervention therapy in 98 CHD patients.Left ventricular end-diastolic diameter（LVEDD）and ejection fraction（EF） were determinated by echocardiography.Results The intervention therapy was successful in all patients.Compared to 1day before,plasma levels of NTproBNP on the 1st and 3rd day after therapy were significantly decreased in the patients with ventricular septal defect（VSD）or patent ductus arteriosus（PDA）（P〈0.01）,which were significantly increased on the 1st day and decreased on the 3rd day in the patients with atrial septal defect（ASD）（P〈0.01）.There was no significant change in plasma cTnT before and after intervention therapy in all cases（P〈0.05）.Compared to 1day before,LVEDD was decreased and EF was increased on the3 rd day after therapy in the patients with PDA and VSD（P〈0.01）,which were not in the patients with ASD（P〈0.05）.Conclusion Interventional therapy can obviously improve heart function without obvious myocardial injury in the patients with CHD.Plasma NT-proBNP detection is helpful in the evaluation of heart function in the patients with CHD underwent interventional therapy.

关 键 词：先天性心脏病 心脏介入治疗 N末端脑钠肽前体 心脏肌钙蛋白T 

分 类 号：R541[医药卫生—心血管疾病]