经皮房间隔缺损封堵术对房间隔缺损患儿心肌损伤标志物及远期预后的影响  

Effect of Percutaneous Atrial Septal Defect Closure on Myocardial Injury Markers and Long-term Prognosis in Children with Atrial Septal Defect

作　　者：黄春瑜[1] 周云国[1] 许飞[1] 段君凯[1] HUANG Chunyu;ZHOU Yunguo;XU Fei;DUAN Junkai(不详;Pediatric Cardiology Treatment Center,Jiangxi Provincial Children's Hospital,Nanchang 330000,China)

机构地区：[1]江西省儿童医院小儿心脏病治疗中心,江西南昌330000

出　　处：《中国医学创新》2024年第21期15-19,共5页Medical Innovation of China

摘　　要：目的:探究经皮房间隔缺损(atrial septal defect,ASD)封堵术对ASD患儿心肌损伤标志物及远期预后的影响。方法:采用回顾性研究,纳入的80例ASD患儿为江西省儿童医院2020年1月—2021年12月收治,按照治疗方式的不同将其分为A组(n=38)及B组(n=42)。A组患儿实施传统体外循环ASD修补术,B组患儿采用经皮ASD封堵术治疗。比较两组手术相关指标、炎症因子[超敏C反应蛋白(hypersensitivity C reactive protein,hs-CRP)、白介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、心肌损伤标志物[肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、心肌肌钙蛋白I(cardiac troponin I,cTnI)]及右室功能,并统计术后并发症发生情况。结果:B组手术时间、术后住院时间均较A组短,输血率较A组低(P<0.05);术前,两组血清hs-CRP、IL-6、TNF-α水平比较,差异均无统计学意义(P>0.05);术后1 d,两组上述炎症因子水平均升高,但B组均低于A组(P<0.05);术前,两组血清CK-MB、cTnI水平比较,差异均无统计学意义(P>0.05);术后1 d,两组上述血清指标均升高,但B组均低于A组(P<0.05);术前,两组右心室舒张末期面积、右心室收缩末期面积比较,差异均无统计学意义(P>0.05);术后6个月,两组以上指标均下降,且B组均小于A组(P<0.05);两组并发症发生率比较,差异无统计学意义(χ^(2)=0.459,P>0.05)。结论:ASD患儿应用经皮ASD封堵术,疗效显著,能减轻炎症反应和心肌损伤,改善右室功能,且安全性良好。Objective:To investigate the effect of percutaneous atrial septal defect(ASD)occlusion on myocardial injury markers and long-term prognosis in children with ASD.Method:Using a retrospective study,80 children with ASD admitted to Jiangxi Provincial Children's Hospital from January 2020 to December 2021 were divided into group A(n=38)and group B(n=42)according to different treatment methods.Children in group A were treated with traditional extracorporeal circulation ASD repair and children in group B were treated with percutaneous ASD occlusion.Operation related indexes,inflammatory factors[hypersensitivity C reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],myocardial injury markers[creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)]and right ventricular function were compared between the two groups,and the incidence of postoperative complications were measured.Result:The operation time and postoperative hospitalization time of group B were shorter than those of group A,and the blood transfusion rate was lower than that of group A(P<0.05).Before operation,there were no significant differences in serum hs-CRP,IL-6 and TNF-αlevels between the two groups(P>0.05).1 day after operation,the levels of above inflammatory factors were increased in both groups,but those in group B were lower than those in group A(P<0.05).Before operation,there were no significant differences in serum CK-MB and cTnI levels between the two groups(P>0.05).1 day after operation,the above serum indexes in both groups were increased,but those in group B were lower than those in group A(P<0.05).Before operation,there were no significant differences in right ventricular end-diastolic area and right ventricular end-systolic area between two groups(P>0.05).6 months after operation,the above indexes of both groups were decreased,and those in group B were smaller than those in group A(P<0.05).There was no significant difference in complication rate between the two groups(χ^(2)=0.459,P>0.05).Conclusion:The applicati

关 键 词：房间隔缺损 儿童 经皮房间隔缺损封堵术 心肌损伤标志物 远期预后 

分 类 号：R726.5[医药卫生—儿科]