先天性心脏病患儿介入治疗前后血浆脑钠尿肽水平与心脏功能的关系  

Relationship between brain natriuretic peptide level and cardiac functions before and after interventional therapy in children with congenital heart disease

作　　者：巩洁[1] 任晖[1] 赵启伟[2] 张军康[1] 王甲文[1] 李静[1] 郑时康[1] 

机构地区：[1]安康市中心医院心血管内科,陕西安康725000 [2]安康市中心医院超声科,陕西安康725000

出　　处：《心脏杂志》2016年第2期189-191,共3页Chinese Heart Journal

摘　　要：目的探讨先天性心脏病(CHD)患儿血浆脑尿钠肽(BNP)水平与心脏功能的关系及其在心导管介入治疗前后的变化特点。方法依据纽约大学儿童心力衰竭指数(NYUPHFI)对先天性心脏病患儿心脏功能进行评定,并分为并发心力衰竭组(心衰组,n=18)及未并发心衰组(非心衰组,n=25);利用超声心动图检测两组的左室射血分数(LVEF);采用罗氏床旁快速定量诊断仪测定全血BNP含量。结果入院时及介入术后心衰组及非心衰组间患儿血浆BNP、NYUPHFI及LVEF均有显著性差异(P<0.05,P<0.01),两组在介入治疗之后血浆BNP均显著下降(P<0.01);患儿血浆BNP浓度与LVEF呈显著负相关(r=-0.53,P<0.01);血浆BNP浓度与NYUPHFI呈显著正相关(r=0.61,P<0.01)。心衰组的先心病患儿血浆BNP浓度与LVEF呈显著负相关(r=-0.62,P<0.01),且血浆BNP浓度与NYUPHFI呈正相关(r=0.78,P<0.01),但在非心衰组未见有统计学意义的相关性。结论先天性心脏病患儿血浆BNP与心脏功能密切相关,介入治疗后随着心脏功能的改善BNP浓度下降。AIM To investigate the plasma levels of B-type natriuretic peptide （BNP） in children with congenital heart disease （CHD） and their correlation with cardiac functions before and after transeatheter closure of defects. METHODS Assessment of the severity of heart failure in pediatric patients with CHD was performed according to the New York University Pediatric Heart Failure Index （NYUPHFI）. Forty-three children with CHD were divided into the group with heart failure and the group without heart failure. LVEF was measured using Doppler velocimetry and two-dimensional echocardiography. BNP was measured by Roche rapid and quantitative analyzer. RESULTS There was a significant difference in plasma concentration of BNP, NYUPHFI and LVEF between groups before and after catheter closure of the defect （P 〈 0. 05, P 〈 0. 01 ）. Plasma BNP concentration significantly decreased after surgery in both groups （P 〈 0. 01 ）. In all patients, BNP concentration was negatively correlated with LVEF （r = - 0. 53, P 〈 0. 01 ） and positively correlated with NYUPHFI （ r = 0.61, P 〈 0. 01 ）. In the heart failure group, BNP concentration was negatively correlated with LVEF （ r = - 0. 62, P 〈 0. 01 ） and positively correlated with NYUPHFI （r = 0. 78, P 〈 0. 01 ）. However, there was no significant correlation between BNP and LVEF and between BNP and NYUPHFI in the group without heart failure. CONCLUSION Plasma BNP concentration significantly correlates with the indexes of cardiac functions in children with CHD. After catheter closure of the defect, plasma BNP concentration is significantly decreased with improvement of cardiac functions.

关 键 词：心脏病 先天性 脑钠尿肽 心脏功能 

分 类 号：R541.1[医药卫生—心血管疾病]