摘要
目的 探讨血清高迁移率族蛋白B1(HMGB1)联合心脏Tei指数对先天性心脏病(CHD)患儿并发肺动脉高压(PAH)的诊断价值。方法 选取152例CHD患儿为CHD组,入院后行右心导管检查术,根据是否并发PAH分为PAH组(n=39)、非PAH组(n=113);同期选取48名健康儿童为对照组。收集各组临床资料,包括性别、年龄、BMI、N末端B型钠尿肽前体(NT-proBNP)、超声心动图指标[左心室舒张末内径(LVEDD)、左心房内径(LAD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)];分别于CHD患儿入院后次日及对照组体检时用酶联免疫吸附法检测HMGB1;两组入院后行超声心动图检查,计算心脏Tei指数;受试者工作特征(ROC)曲线分析血清HMGB1水平和心脏Tei指数对CHD患儿并发PAH的诊断价值。结果 CHD组血清HMGB1水平、心脏Tei指数均高于对照组(P均<0.05)。PAH组NT-proBNP、LAD、HMGB1、Tei指数高于非PAH组,LVEF低于PAH组(P均<0.05)。多因素Logistic回归分析结果显示,NT-proBNP、HMGB1、Tei指数升高为CHD患儿并发PAH的独立危险因素,LVEF升高为独立保护因素(P均<0.05)。ROC曲线分析显示,血清HMGB1水平、心脏Tei指数单独与联合诊断CHD患儿并发PAH的曲线下面积分别为0.790、0.797、0.885,血清HMGB1水平联合心脏Tei指数诊断CHD患儿并发PAH的曲线下面积大于二者单独诊断(P<0.05)。结论 血清HMGB1水平与心脏Tei指数联合诊断CHD患儿并发PAH的诊断价值较高。
Objective To investigate the diagnostic value of serum high-mobility group protein B1(HMGB1) combined with cardiac Tei index in children with congenital heart disease(CHD) complicated with pulmonary arterial hypertension(PAH). Methods A total of 152 children with CHD were selected as the CHD group and they underwent right heart catheterization after admission. They were divided into PAH group(n=39) and non-PAH group(n=113) according to whether PAH occurred or not. At the same time, 48 healthy children were selected as the control group. Clinical data of each group were collected, including gender, age, BMI, N-terminal pro-B-type natriuretic peptide(NT-proBNP), echocardiographic indicators [left ventricular end-diastolic diameter(LVEDD), left atrial diameter(LAD), left ventricular ejection fraction(LVEF), and left ventricular short-axis shortening rate(LVFS)]. HMGB1 was detected by enzymelinked immunosorbent assay on the next day after the admission in children with CHD and at the physical examination in the children in the control group. Echocardiographic examination was performed in the two groups after admission, and cardiac Tei index was calculated. The diagnostic value of serum HMGB1 level and cardiac Tei index in patients with CHD complicated with PAH was analyzed by ROC curve. Results The serum HMGB1 level and cardiac Tei index in the CHD group were higher than those in the control group(both P<0. 05). NT-proBNP, LAD, HMGB1 and Tei index in the PAH group were higher than those in the non-PAH group, and LVEF was lower than that in the PAH group(all P<0. 05). Multivariate Logistic regression analysis showed that the increase of NT-proBNP, HMGB1 and Tei index were independent risk factors for PAH in children with CHD, and the increase of LVEF was independent protective factor(all P<0. 05). The ROC curve analysis showed that the area under the curve of serum HMGB1 level and cardiac Tei index alone and combined in the diagnosis of PAH in children with CHD were 0. 790, 0. 797 and 0. 885, respectively, and the are
作者
史蓓
潘洁怡
杨优维
SHI Bei;PAN Jieyi;YANG Youwei(ECG Room,Shanghai First Maternity and Infant Health Hospital,Shanghai 200333,China;不详)
出处
《山东医药》
CAS
2023年第7期34-37,共4页
Shandong Medical Journal
基金
上海市卫生行业临床研究项目(20204Y0051)。
