先天性心脏病患儿手术前后血浆肾上腺髓质素的变化  

Changes of plasma adrenomedullin in children with congenital heart disease before and after operations

作　　者：阳明玉[1] 王丹[1] 宋晓丹[1] 秦静庭[1] 王昕[1] 

机构地区：[1]桂林医学院附属医院儿科,广西桂林541001

出　　处：《华夏医学》2016年第6期18-21,共4页Acta Medicinae Sinica

基　　金：广西壮族自治区教育厅科研资助项目(LX2014261)

摘　　要：目的:探讨先天性心脏病患儿手术前后血浆肾上腺髓质素(Adrenomedullin,ADM)水平的变化及与心功能的关系。方法:应用放射免疫分析法(RIA)测定35例先天性心脏病患儿术前、术后第1天、术后半个月、术后6个月血浆ADM浓度,30例健康体检儿童做对照组,检测方法同上。同时用彩色多普勒声心动图测定所有患儿左室射血分数(LVEF))。结果:先天性心脏病术前ADM水平高于正常对照组,有统计学差异(P<0.05),术后第1天和术后半个月与术前比较差异均无统计学意义(P>0.05),术后6个月与术前比较差异有统计学意义(P<0.01),术后6个月与对照组比较差异无统计学意义(P>0.05)。结论:先天性心脏病患儿存在心室容量负荷和压力负荷增加,刺激心脏合成与释放ADM增多,术后血流动力学逐渐恢复正常,ADM也恢复正常。Objective： To investigate the relationship between the changes of plasma adrenomedullin （ADM） and cardiac functions in children with congenital heart disease before and after operations. Methods： RIA was used to determine the plasma ADM concentration before operation, the 1st day after operation, half a month and 6 months after operation in 35 cases of congenital heart disease, another 30 healthy children were selected as the control group with the above-mentioned determination methods. Meanwhile, color doppler echocardiography was applied to detecting LVEF of patients. Results： ADM level of patients before operation was higher than that of the control group, which was of statistical difference （P 〈 0.05）; compared with the ADM in patients before operation, there was no statistical difference in patients 1 day and half a month after operations （P 〉 0.05）; there was of statistical difference of the ADM level between patients before operation and 6 months after operation, but no statistical difference of ADM between patients 6 months afteroperation and the healthy control. Conclusion： Children with congenital heart disease have increased ventricular volume load and pressure load, it will stimulate the heart synthesis and the release of ADM, make the postoperative hemodynamic and ADM gradually return to normal.

关 键 词：先天性心脏病 肾上腺髓质素 心功能 手术治疗 

分 类 号：R541.1[医药卫生—心血管疾病]