高压氧联合波生坦治疗对先天性心脏病伴重度肺动脉高压患儿血清NT-proBNP及galectins-3表达的影响  

Effect of hyperbaric oxygen therapy combined with Bosentan on the serum expressions of NT-proBNP and galectins-3 in children with congenital heart disease and severe pulmonary hypertension

作　　者：杨蕊华[1] 王俊英[1] 王振芳[1] 刘洁琼[1] 张小平[1] 崔涛[1] 孙晔 刘丽华 孙晶 Yang Ruihua;Wang Junying;Wang Zhenfang;Liu Jieqiong;Zhang Xiaoping;Cui Tao;Sun Ye;Liu Lihua;Sun Jing(Department of Cardiology,Children’s Hospital of Shanxi,Taiyuan 030013,China)

机构地区：[1]山西省儿童医院心内科,太原030013

出　　处：《中华航海医学与高气压医学杂志》2021年第4期455-459,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧辅助波生坦治疗对先天性心脏病(CHD)伴重度肺动脉高压(PAH)患儿血清氨基末端脑钠素原(NT-proBNP)及半乳糖凝集素3(galectins-3)表达的影响。方法收集2015年1月至2019年12月在山西省儿童医院心内科诊治的CHD并发重度PAH 80例患儿的临床资料。根据治疗方法将患儿分为观察组和对照组,每组40例。对照组患者在常规治疗的基础上给予波生坦治疗,观察组在对照组治疗的基础上给予高压氧治疗。治疗3个疗程后观察2组患者治疗效果。在治疗前后采用超声心动图检测肺动脉平均压(MPAP)、平均体循环动脉压(MSAP)、体循环阻力(SVR)、肺循环阻力(PVR)、肺动脉压/主动脉压(Pp/Ps)。在治疗前后清晨空腹采集桡动脉血2 ml,使用血气分析仪检测动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))及氧合指数(OI)。采用超声心动图计算每分钟心输出量(CO)和心指数(CI)。使用ELISA法检测NT-proBNP、galectins-3的表达水平。观察2组患者的治疗效果、血流动力学指标、心功能、NT-proBNP及galectins-3等。结果治疗3个疗程后,观察组患者治疗总有效率(90.0%)显著高于对照组(70.0%),差异有统计学意义(P<0.05)。2组患者治疗后MPAP、MSAP、SVR、PVR、Pp/Ps水平较本组治疗前均明显下降,且观察组治疗后较对照组下降更显著,差异均有统计学意义(P<0.05)。2组患者PaO2、OI、CI、CO较治疗前均明显升高,且观察组治疗后较对照组升高更显著,差异均有统计学意义(P<0.05)。2组患者血清NT-proBNP、galectins-3水平明显降低,且观察组治疗后较对照组降低更显著,差异均有统计学意义(P<0.05)。结论高压氧联合波生坦治疗CHD合并PAH患者的临床效果较好,可显著改善肺循环血流动力指标和心功能,降低NT-proBNP、galectins-3的表达水平,有利于患儿预后。Objective To investigate the effect of hyperbaric oxygen therapy combined with Bosentan on the serum expressions of NT-proBNP and galectins-3 in children with congenital heart disease(CHD)and severe pulmonary arterial hypertension(PAH).Methods The clinical data of 80 children with CHD and severe PAH admitted to the Department of Cardiology of Children’s Hospital of Shanxi from January 2015 to December 2019 were collected.According to the treatment,the children were divided into observation group(n=40)and control group(n=40).The control group was given Bosentan and conventional treatment,and the observation group was given hyperbaric oxygen therapy on the basis of the treatments in the control group.The therapeutic effects of the two groups were observed after three courses of treatment.Mean pulmonary arterial pressure(MPAP),mean systemic arterial pressure(MSAP),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR),and pulmonary artery pressure/aortic pressure(Pp/Ps)were measured by echocardiography before and after treatment.Two milliliters of radial artery blood were collected on an empty stomach before and after treatment,and partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),and oxygenation index(OI)were measured by blood gas analyzer.Cardiac output(CO)per minute and cardiac index(CI)were calculated by echocardiography.Serum levels of amino-terminal pro-brain natriuretic peptide(NT-proBNP)and galectins-3 were detected by ELISA.The therapeutic effect,hemodynamic indexes,cardiac function,and the levels of NT-proBNP and galectins-3 were observed.Results After three courses of treatment,the total effective rate in the observation group(90.0%)was significantly higher than that in the control group(70.0%),and the difference was statistically significant(P<0.05).The levels of MPAP,MSAP,SVR,PVR,and Pp/Ps in the two groups were decreased after treatment,and those in the observation group decreased more significantly after treatment than those in the control group,with statistica

关 键 词：高压氧 波生坦 先天性心脏病 重度肺动脉高压 氨基末端脑钠素原 半乳糖凝集素3 

分 类 号：R725.4[医药卫生—儿科] R459.6[医药卫生—临床医学]