先天性心脏病合并不同程度肺动脉高压患儿手术前后血浆脑钠肽前体的变化  

Changes of plasma pro-brain natriuretic peptide before and after operation in children with congenital heart disease with different degrees of pulmonary hypertension

作　　者：郭俊晓[1] 任杰[1] 张玉龙[1] 刘志平[1] GUO Junxiao;REN Jie;ZHANG Yulong;LIU Zhiping(Department of Cardiac Great Vascular Surgery,Affiliated Hospital of Inner Mogalin Medical University,Inner Mongolia Autonomous Region,Hohhot100050,China)

机构地区：[1]内蒙古医科大学附属医院心脏大血管外科,内蒙古呼和浩特100050

出　　处：《中国医药导报》2021年第2期56-60,共5页China Medical Herald

摘　　要：目的评价患儿血浆脑钠肽前体(NT-proBNP)在先天性心脏病合并不同程度肺动脉高压(PAH)手术前后不同时间的改变。方法收集2015年1月-2018年1月就诊于内蒙古医科大学附属医院诊治的先天性心脏病患儿60例。根据肺动脉压力分为四组,其中无PAH组16例,轻度PAH组16例,中度PAH组14例,重度PAH组14例。术前采用经胸超声心动图估测肺动脉收缩压,比较合并不同程度PAH组患儿手术前后不同时间血浆NT-proBNP浓度的变化。结果四组术前、术后NT-proBNP水平整体比较,差异有统计学意义(P<0.05)。其中无PAH组与轻度PAH组患儿血浆NT-proBNP水平比较,差异无统计学意义(P>0.05);重度、中度PAH组血浆NT-proBNP水平高于无PAH组与轻度PAH组比较,差异有统计学意义(P<0.05);重度PAH组血浆NT-proBNP水平低于中度PAH组患儿,差异有统计学意义(P<0.05)。术后轻度PAH组NT-proBNP水平高于术前,差异有统计学意义(P<0.05)。结论在临床中通过研究左向右分流先天性心脏病患儿手术前后血浆NT-proBNP水平随PAH严重程度的增高而逐渐升高,可作为评价PAH程度的一项指标,有助于保障患者的健康,值得在实际中应用。Objective To evaluate the changes of pro-brain natriuretic peptide(NT-proBNP)in children with congenital heart disease combined with different degrees of pulmonary hypertension(PAH)at different times before and after surgery.Methods A total of 60 children with congenital heart disease who were diagnosed and treated in the Affiliated Hospital of Inner Mongolia Medical University were collected from January 2015 to January 2018.According to the pulmonary artery pressure,they were divided into four groups,including 16 cases in the no PAH group,16 cases in the mild PAH group,14 cases in the moderate PAH group,and 14 cases in the severe PAH group.Preoperative transthoracic echocardiography was used to estimate the pulmonary artery systolic blood pressure,and the changes in plasma NT-proBNP concentrations at different times before and after the operation in children with different degrees of PAH were compared.Results The overall comparison of NT-proBNP levels before and after in the four groups was statistically significant(P<0.05).Among them,there was no significant difference in plasma NT-proBNP levels between the no-PAH group and the mild PAH group(P>0.05);the plasma NT-proBNP levels in the severe and moderate PAH groups were higher than those in the no PAH group and the mild PAH group,and the differences were statistically significant(P<0.05);the plasma NT-proBNP level in the severe PAH group was lower than that in the moderate PAH group,and the difference was statistically significant(P<0.05).The level of NT-proBNP in the mild PAH group after operation was higher than that before operation,and the difference was statistically significant(P<0.05).Conclusion In clinical studies,the plasma NT-proBNP level before and after surgery in children with congenital heart disease with left-to-right shunt gradually increases with the severity of PAH,which can be used as an indicator to evaluate the degree of PAH and help protect the health of patients,it is worth applying in practice.

关 键 词：脑钠肽前体 先天性心脏病 肺动脉高压 临床意义 

分 类 号：R541[医药卫生—心血管疾病]