摘要
目的研究先天性心脏病（CHD）的发病机制，探讨结缔组织生长因子（CTGF）在CHD及肺动脉高压（Pn）早期诊断中的价值。方法选取山西省儿童医院心内科和心胸外科2012年9月至2013年1月收治的CHD患儿中的66例，据心脏彩色多普勒超声估算肺动脉收缩乐，分为单纯CHD组16例，合并轻度PH组18例，合并中度PH组17例，合并重度PH组15例；按类型分为室间隔缺损（VSD）23例，房间隔缺损（ASD）17例，动脉导管未闭（PDA）14例，复合型（合并2种以上的先天性心血管异常）12例。随机数字表法抽取同期江西省儿童医院门诊体检的20例健康儿童作为健康对照组。通过双抗体夹心酶链免疫吸附法测定研究对象血清中CTGF水平，按不同肺动脉收缩压和不同类型CHD将各组问血清CTGF水平分别进行比较，分析CHD各组患儿血清CTGF水平与肺动脉收缩压的相关性。结果定量检测表明CHD各组患儿血清中CTGF水平显著高于健康对照组（P〈0．05），CHD合并PH各组患儿血清CTGF水平均高于单纯CHD组（P〈0．05），随着肺动脉压力的升高，CHD患儿血清CTGF水平逐级上升（P〈0．05）。相关分析显示CHD各组患儿血清CTGF水平与肺动脉压力呈正相关（r=0．670，P=0．005；r=0．514，P=0．029；r=0．517，P=0．034；r=0．707，P=0．003）。不同类型CHD患儿血清CTGF水平比较差异无统计学意义（F=0．270，P=0．847）。结论CHD早期（术合并PH时）已经存在心肌纤维化损害，当合并PH时，心肌纤维化随肺动脉压力的升高逐渐加重，但心肌纤维化程度与CHD的类型无关．
Objective To further study the pathogenesis for congenital heart disease （CHD） and connective tissue growth factor（CTGF） for the early diagnosis of CHD and puhnonary hypertension（PH）. Methods Sixty - six cases of children with CHD were selected from the thoracic surgery who were performed in the Children＇s Hospital of Shanxi Province during the period between Sep. 2012 and Jan. 2013. Based on the cardiac color Doppler estimation of the pulmonary artery systolic pressure,they were classified into several groups：unincorporated PH group with 16 cases, mild PH group with 18 cases,moderate PH group with 17 cases, and severe PH group with 15 cases. Based on types,the 66 cases could be classified as ventricular septal defect （ VSD ） group with 23 cases, atrial septal defect （ ASD ） group with 17 cases ,patent ductus arteriosus（PDA） group with 14 cases, and composite（ including 2 or more of the congenital cardiovascular anomalies） group with 12 eases. Twenty healthy children who had medical examination over the same period in the Children＇s Hospital of Shanxi Province were randomly chosen as the healthy control group. The serum concentration of CTGF in the research objects were determined with the aid of double antibody sandwich enzyme - linked immunosorbent assay method. According to the different puhnonary artery systolic pressure and different types of CHD, the serum concentration of CTGF were compared among groups. The correlation of between the CTGF concentration in the serum and pulmonary artery systolic pressure were also analyzed among the groups of children with CHD. Results Quantitative measurement revealed that the serum CTGF concentration measured in the groups of children with CHD were significantly higher than that in the healthy control group（ P 〈 0.05 ） ;the serum CTGF concentration of the clil- dren with CHD and PH was higher than that in the group of children with CHD alone（ P 〈 0.05 ）. With the increas, in pulmonapy artery pressure ,CHD patients sermn level
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第1期38-40,共3页
Chinese Journal of Applied Clinical Pediatrics
基金
基金项目：山西省儿童医院院内资助科研项目（201126）
关键词
先天性心脏病
肺动脉高压
结缔组织生长因子
Congenital heart disease
Pulmonary hypertension
Connective tissue growth factor
