组织多普勒Tei指数联合氨基末端脑钠肽前体评价房间隔缺损患儿介入治疗前后右心功能  

Evaluation effects of cardiac tissue doppler Tel index and serum N-terminal pro-brain natriuretic peptide on the right cardiac function before and after Interventional therapy in children with atrial septal defect

作　　者：李跃征 何小梅[3] 高磊[2] 刘君[2] 

机构地区：[1]武警山东总队聊城市支队卫生队,252000 [2]河北医科大学第一医院心内科 [3]河北医科大学第一医院心脏超声科

出　　处：《中国综合临床》2016年第2期109-112,共4页Clinical Medicine of China

基　　金：河北省医学科学研究重点课题计划（ZD20140355）

摘　　要：目的观察组织多普勒Tel（TDI-Tei）指数与NT-proBNP浓度在房间隔缺损（ASD）患儿介入治疗前后的变化，探讨两者对患儿介入治疗前后右心功能改善的综合评定价值。方法选择河北医科大学第一医院2013年6月至2015年6月住院行介入治疗成功的90例ASD患儿作为ASD组，男48例，女42例；年龄3．0～13．0岁，平均（5．4±2．7）岁。选取同期年龄及性别与之相匹配的体检健康儿童50名为健康对照组。分别在术前、术后第7夫、术后6个月运用超声组织多普勒方法测定右心室Tei指数，并采用双向侧流免疫法测定血清NT—proBNP浓度，分别比较介入术前后两者的变化并分析其相关性。结果（1）右心室TDI—Tei指数的变化：ASD组术前右心室TDI-Tel指数大于健康对照组，差异有统计学意义（0．56±0．09与0．31±0．05，P〈0．01），介入术后ASD组各时间点右心室TDI-Tei指数逐渐下降，尤以术后6个月降低最明显（P〈0．01），术前右心室TDI-Tel指数与术后7d、术后6个月比较差异有统计学意义（0．56±0．09与0．44±0．06、0．33±0．04，t值分别为22.56、23．27，p均〈0．05）。术后7d与健康对照组相比差异仍有统计学意义（P〈0．05），术后6个月与健康对照组相比差异无统计学意义（P〉0．05）。（2）血清NT-proBNP浓度的变化lASD组术前血清NT-proBNP浓度高于健康对照组，差异有统计学意义[（259．49±43．99）n吕／L与（102．11±34．53）ng／L，P〈0．01]，介入术后ASD组各时间点血清NT—proBNP浓度均较术前降低，尤以术后6个月降低最明显（P〈0．01），术前NT—proBNP浓度与术后7d、术后6个月比较差异有统计学意义[（259．49±43．99）ng／L与（192．93±56．46）、（108．46±36．88）ng/L，P均〈0．05]。术后7d与健康对照组相比差异仍有统计学意义（P〈0．05），术后6个月与健康对照组相比差异无统计学意义（P�Objective To observe the changes of tissue doppler Tel index （TDI-Tei index） and N- terminal pro-brain natriuretic peptide （NT-proBNP） levels in children with atrial septal defect （ASD） before and after interventional therapy, in order to investigate the evaluation value of the two parameters on the improvements of right cardiac function. Methods Ninety children with ASD who were treated in the First Hospital of Hebei Medical University from June 2013 to June 2015 as the ASD group,including 48 male and 42 female at the age of （3.0-13.0） years old, and the average age was （5.4±2. 7） years old. Fifty healthy children with matched age and gender as the control group. Concentrations of serum NT-proBNP were measured by using Bi-directional lateral flow immunoassav before and the 7th dav and 6th month after enrdiac catheterization, respectively. The right ventricular Tei index （RV-Tei index） was measured by tissue doppler Imaging. The changes and the correlations of parameters before and after interventional therapy were compared and analyzed respectively. Results （ 1 ） Before interventional therapy, the fight ventricular TDI-Tei index in ASD group was higher than control group （0. 56 ± 0. 09 vs 0. 31 ± 0.05, P〈 0. 01 ）, and the TDI-Tei index was decreased gradually at different time points after interventional therapy in ASD group, especially at the 6th month was lowest（P〈0. 01 ） ; TDI-Tei indexes at before and the 7th day and 6th month after the procedure were significantly different （ 0. 56 ± 0. 09 vs 0. 44 ±0. 06, 0.56±0. 09 vs 0. 33 ± 0.04; t = 22. 56, 23.27 ; P 〈 0. 05 ）. Compared with control group, there was significant difference about the TDI-Tei index in ASD group at the 7th day after transcatheter closure（P〈0. 05） , while there was no significant difference about TDI-Tei index at the 6th month （P〉0. 05） . （2） Before interventional therapy, the level of serum NT-proBNP in ASD group was higher than control group（（259.49±43.99） ng/L vs

关 键 词：组织多普勒-Tei指数 氨基末端脑钠肽前体 房间隔缺损 介入治疗 右心功能 

分 类 号：R540.45[医药卫生—心血管疾病]