血清氨基末端脑钠肽前体浓度变化与肺动脉高压的关系  

Corelation between serum NT-proBNP and pulmonary artery hypertension in adult with left-to-right shunt congenital heart disease

作　　者：陈妍汶 杨勇[1] 邹艳[1] 

机构地区：[1]四川省绵阳市中心医院,四川绵阳621000

出　　处：《热带医学杂志》2015年第4期511-513,共3页Journal of Tropical Medicine

摘　　要：目的通过检测成人先天性心脏病介入封堵术前术后血清氨基末端脑钠肽前体(NT-pro BNP)浓度,探讨血清NT-pro BNP浓度与肺动脉高压(PAH)的关系,为肺动脉高压的诊断、病情程度的评估和预后判断提供依据。方法将2012年1月至2013年6月在四川省绵阳市中心医院成功行封堵术的先天性心脏病患者106例作为观察组,20例表观健康者为对照组。依据肺动脉平均压将观察组分为三组:无PAH组(n=52)、轻度PAH组(n=18)、中重度PAH组(n=36)。所有患者术前均行右心导管检查,测定右房压、右室压、肺动脉收缩压、肺动脉平均压、全肺阻力。同时测定患者术前术后血清NT-pro BNP浓度,并对结果进行分析。结果在行封堵手术前,观察组血清NT-pro BNP浓度明显高于对照组(P<0.05),各观察组血清NT-pro BNP浓度为中重度PAH组>轻度PAH组>无PAH组,各组之间差异均有统计学意义(P<0.05)。各观察组的肺动脉平均压、肺动脉收缩压和全肺阻力与血清NT-pro BNP浓度呈正相关,其相关系数分别为0.887(P=0.000)、0.921(P=0.000)和0.844(P=0.000)。在行封堵手术后,观察组血清NT-pro BNP浓度明显低于手术前,差异有统计学意义(P<0.05)。结论血清NT-pro BNP浓度可以作为PAH的诊断、反映病情程度及判断预后的指标之一。Objective To investigate the corelation between the level of serum amino-terminal pro-brain natriuretic peptide（NT-pro BNP） and pulmonary artery hypertension（PAH）in adult with left-to-right shunt congenital heart disease.Methods 106 patients with congenital heart disease were enrolled as treatment group,and 20 healthy subjects as control group.Patients in treatment group were divided into three groups according to their pulmonary artery mean pressure ：Nonpulmonary hypertension group（n=52）,mild pulmonary hypertension group（n=18）,and moderate and severe pulmonary hypertension group（n=36）.The right atrial pressure,right ventricular pressure and pulmonary artery pressure were measured by right heart catheterization.The serum NT-pro BNP concentrations were assayed.Results Before transcatheter closure,the level of NT-pro BNP was higher in the treatment group than that in the control group（P〈0.05）.The level of serum NT-pro BNP was the highest in the serious or moderate PAH group,higher in the mild PAH group and high in the non-PAH group（P〈0.05）.There was a positive correlation between mean pulmonary arterial pressure（m PAP）,pulmonary artery systolic pressure（s PAP）,pulmonary vascular resistance（PVR） and the level of NT-pro BNP before transcatheter closure.After transcatheter closure the level of NT-pro BNP in the treatment group reduced significantly（P〈0.05）.Conclusion The serum NT-pro BNP level in adult left-to-right shunt congenital heart disease was gradually increased with the elevating of pulmonary artery pressure.It may be used as a marker to evaluate the degree of PAH.

关 键 词：氨基末端脑钠肽前体 先天性心脏病 肺动脉高压 介入封堵术 

分 类 号：R541.1[医药卫生—心血管疾病]