左向右分流型先天性心脏病病儿血浆BNP和CT1变化.doc

文档介绍：左向右分流型先天性心脏病病儿血浆BNP和CT1变化
作者:聂娜娜宁险峰曹文张欣李自普

【摘要】目的探讨左向右分流先天性心脏病(CHD)病儿血浆脑钠肽(BNP)、心脏营养素1(CT1)水平的变化及临床意义。方法应用ELISA法测定25例左向右分流CHD病儿和10例正常儿童血浆BNP和CT1水平,观察血浆BNP和CT1水平与肺动脉压力、左心室射血分数(EF)、左心室短轴缩短率(FS)、左心室舒张末内径(LVIDd)、左心室收缩末内径(LVIDs)和左心室心肌质量指数(LVMI)的关系。结果与正常儿童比较,左向右分流CHD病儿血浆BNP和CT1水平明显升高(t=、,P<);肺动脉高压病儿血浆CT1水平明显高于正常肺动脉压病儿(t=,P<),且左向右分流CHD病儿血浆CT1水平与肺动脉压力呈正相关(r=,P<),但与EF、FS、LVIDd、LVIDs和LVMI无相关性(P>);左向右分流CHD病儿血浆BNP水平与EF、FS、LVIDd、LVIDs、LVMI和肺动脉压力均无相关性(P>)。结论血浆BNP和CT1水平能较好地反映左向右分流型CHD病儿的心功能状态,血浆CT1水平随肺动脉压力升高而升高。
【关键词】心脏缺损,先天性;脑钠肽;心脏营养素1
[ABSTRACT] Objective To investigate the changes and clinical significance of plasma levels of cardiotrophin1 (CT1) and brain natriuretic peptide (BNP) in children with lefttoright shunt congenital heart disease (CHD). Methods The plasma concentrations of BNP and CT1 of 25 sick children and 10 healthy ones were measured by using enzyme immunoassay. The relationship between CT1 or BNP and pulmonary artery pressure (PAP), ejection fraction, fractional shortening, left ventricular internal diameter at enddiastole (LVIDd), left ventricular internal diameter at endsystole (LVIDs), and left ventricular mass index(LVMI) were studied. pared to normal children, the plasma CT1 and BNP were significantly elevated in the sick children (t=,;P<); the plasma CT1 in those with pulmonary hypertension was higher than that with normal PAP(t=,P<). The plasma CT1 in the sick children was positively correlated with PAP (r=,P<), but no correlation with ejection fraction, fractional shortening, LVIDd, LVIDs, LVNI and PAP was found (P>). Conclusion The plasma levels of CT1 and BNP can better reflect cardiac status in children with left
toright shunt CHD, and the CT1 levels increase along with the rising of PAP.
[KEY WORDS] heart defects, congenital; brain natriuretic peptide; cardiotrophin1
心脏营养素1 (CT1) 是PENNICA等于1995年利用鼠胚胎干细胞模型克隆出的