摘要
目的观察先天性心脏病(CHD)并心力衰竭(HF)患儿血浆氨基末端脑利钠肽前体(NT-proBNP)水平的变化,分析NT-proBNP与HF严重程度的关系及在心功能评估中的价值。方法选择本院2008年6月-2011年6月住院CHD患儿46例,并根据纽约大学儿童HF指数(NYU PHFI)的评价标准将其分成3组:无HF组(15例)、轻度HF组(16例)、中重度HF组(15例)。选取同期25例健康儿童作为健康对照组。分别留取各组儿童空腹静脉血2 mL,应用ELISA法测定其血浆NT-proBNP水平,同时测定其左心室射血分数(LVEF)、二尖瓣舒张早期流速峰值/二尖瓣舒张晚期流速峰值(E/A值)。分析其血浆NT-proBNP水平与HF严重程度及LVEF、E/A值的相关性。结果血浆NT-proBNP水平与HF严重程度呈明显正相关(r=0.82,P<0.01),HF程度越重,血浆NT-proBNP水平升高越显著;中重度HF组NT-proBNP水平显著高于轻度HF组(P<0.01),轻度HF组NT-proBNP水平显著高于无HF组(P<0.01),无HF组NT-proBNP水平显著高于健康对照组(P<0.05)。血浆NT-proBNP水平与LVEF呈负相关(r=-1.20,P<0.01)。结论血浆NT-proBNP水平随着HF的严重程度增加而升高,检测血浆NT-proBNP对评估CHD并HF患儿病情严重程度及判断预后具有重要临床意义。
Objective To observe the changes of plasma N - terminal pro - brain natriuretic peptide （ NT - proBNP） in children with congenital heart disease （CHD） combined with heart failure （HF）, and analyze the relationship between the severity of HF and NT -proBNP levels, and explore its clinical significance in the diagnosis of HF and cardiac function classification. Methods Forty - six patients with CHD and HF in the Affiliated Hospital of Guilin Medical University were collected randomly from Jun. 2008 to Jun. 2011, and they were divided into 3 groups according to the evaluation criteria of New York University Pediatric Heart Failure Index （NYU PHFI） ：non - HF group （15 pa- tients） ,mild HF group （16 patients） and moderate to severe HF group （15 patients）. Twenty -five healthy children were selected as the healthy control group. Blood samples of all groups were collected. Concentration of plasma NT - proBNP was determined by enzyme - linked immunosorbent assay. The left ventricular ejection fraction （LVEF） and the ratio of early - diastolic peak flow velocity and late - diastolic peak flow velocity （E/A） were determined. The relationships between plasma NT - proBNP levels and modified Ross score and echocardiographic cardiac functional indexes were analyzed. Results Plasma NT - proBNP was positively correlated with the severity of HF（ r = 0. 82, P 〈 0. 01 ）, the more serious the HF was, the higher the plasma NT - proBNP concentration. Plasma NT - preBNP level in moderate to severe HF group was significantly higher than that in mild HF group （P 〈 0. 01 ）, plasma NT- proBNP level in mild HF group was higher than that in non -HF group（P 〈0.01 ） ,and plasma NT- proBNP level in non -HF group was significantly higher than that in healthy control group （ P 〈 0.01 ）. Plasma NT - preBNP level was negatively correlated with LVEF （ r = - 1.20, P 〈 0.01 ）. Conclusions Plasma NT - proBNP concentration will elevate with the increase of the serious degree of HF,which
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第1期19-20,24,共3页
Journal of Applied Clinical Pediatrics
基金
广西壮族自治区卫生厅课题(Z2011175)
关键词
先天性心脏病
氨基末端脑利钠肽
心力衰竭
congenital heart disease
N -terminal pro -brain natriuretic pepfide
heart failure
