摘要
目的了解小儿心脏病患者血浆氨基末端脑利钠肽(brainnatriureticpeptide,BNP)前体(N-pro-BNP)水平与心功能的关系及其在介入治疗前后的变化。方法收集自2004年7月至2005年1月间左向右分流先天性心脏病患儿共58例,所有患儿在介入治疗前后均进行心功能分级的临床评价,通过二维超声心动图测定射血分数(EF)、缩短分数(FS)、左心室舒张末期内径(LVDd)及N-pro-BNP水平,比较介入前后的改变。结果58例均成功接受介入治疗。介入治疗前后LVDd,EF,FS和血浆N-pro-BNP水平分别为36·7±5·2mm比35·4±4·2mm,78·1%±5·3%比75·3%±6·5%(P<0·05),41·1%±5·4%比38·3%±4·9%(P<0·05),194·7±154·7ng/L比561·0±594·2ng/L(P<0·05)。室间隔缺损(VSD)组术前N-pro-BNP水平(68·7±60·8ng/L)明显低于动脉导管未闭(PDA)+房间隔缺损(ASD)组(277·5±279·5ng/L),VSD组术后N-pro-BNP水平(436·8±793·6ng/L)较术前(68·7±60·8ng/L)明显升高(P<0·05),PDA+ASD组手术前后差异无统计学意义。结论介入治疗后48h内EF和FS有所下降,血浆N-pro-BNP水平则明显升高。VSD组内术后N-pro-BNP水平较术前明显升高,推测可能是操作过程中对左心室反复的机械刺激所致。
Objective To investigate the relationship between plasma pro-brain natriuretic peptide （N- pro-BNP） level and heart function, as its well as change before and after interventional therapy. Methods Fiftyeight children with left to right shunt congenital heart diseases were enrolled from July, 2（104 to Jan, 2005. Clinical heart function were categorized and plasma N-pro-BNP concentration were detected. The ejection fraction （EF）, fractional shortening （FS） and left ventricular and diastolic dimension （LVDd） were measured by two-dimensional echocardiography. The relationship between plasma pro-BNP concentration and the echo parameters, and its change before and after interventional therapy were analyzed. Results The plasma N-pro-BNP concentration, LVDd, EF and FS before and after intervention were 194.7 ± 154.7 ng/L vs 561.0 ± 594.2 ng/L （ P 〈 0.05）, 36.7±5.2 mm vs 35.4±4.2 mm （P〈 0.05）, 78.1% ±5.3% vs 75.3% ±6.5% （P 〈 0.05）, 41.1% ± 5.4% vs 38.3% ± 4.9% （ P 〈 0.05）, respectively. VSD patients had significantly lower prcoperational N-pro- BNP level than those of PDA and ASD patients （68.7 ± 60.8 ng/L us 277.5 ± 279.5 ng/L, P 〈0.05）. N-pro- BNP level elevated greatly after interventions in VSD patients （436.8 ± 793.6 ng/L us 68.7 ± 60.8 ng/L, P 〈 0.05）. EF and FS decreased while plasma N-pro-BNP concentration increased within a period of 48 hours after interventions. Conclusion N-pro-BNP level elevated greatly after interventions in VSD patients, which may be related to the physical stimulations to the left ventricle by catheters during interventional procedure.
出处
《中国介入心脏病学杂志》
2006年第5期282-284,共3页
Chinese Journal of Interventional Cardiology
关键词
利钠肽
脑
心脏缺损
先天性
Natriuretic peptide, brain
Heart defects, congenital
