心力衰竭患儿血浆脑钠肽变化及临床意义

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目的探讨心力衰竭患儿血浆脑钠肽(BNP)变化及其与心功能的关系。方法研究对象为2005年4月至2007年1月在宜宾市第二人民医院住院的心力衰竭患儿43例,应用ELISA方法测定患儿血浆BNP浓度,M型超声心动图测量左室射血分数(LVEF)、短轴缩短率(FS),并比较BNP与LVEF、FS的相关性。结果与正常对照组比较,心力衰竭患儿血浆BNP水平明显升高,心功能参数LVEF、FS显著降低(t值分别为8.092、3.780、3.864,P值分别<0.001、<0.01、<0.01)。心衰程度越重,血浆BNP水平升高越明显(F=4.26,P<0.01)。心功能Ⅰ级组患儿血浆BNP水平已明显升高(t=4.708,P<0.01),心功能参数LVEF、FS降低不明显。不同原发病心力衰竭患儿血浆BNP无差别。血浆BNP水平与LVEF和FS存在负相关关系(r分别为-0.568,-0.325,P值分别<0.05,<0.001)。结论心衰患儿血浆BNP水平显著升高,随着患儿心衰程度加重,血浆BNP水平增高越显著。血浆BNP水平是心衰患儿心脏功能更敏感的生化指标。 Objective To investigate the changes of plasma brain natriuretic peptide (BNP) in children with heart failure and its relationship with cardiac function. Methods Forty-three children with heart failure admitted to the Second People’s Hospital of Yibin from April 2005 to January 2007 were enrolled in this study. Plasma BNP levels were measured by ELISA. Left ventricular ejection fraction was measured by M-mode echocardiography (LVEF), short axis shortening (FS), and compared BNP with LVEF, FS correlation. Results Compared with the normal control group, plasma BNP levels and heart function parameters LVEF and FS in children with heart failure were significantly lower (t = 8.092, 3.780 and 3.864, respectively, P <0.001, <0.01, <0.01, respectively). The more severe heart failure, plasma BNP levels increased more significantly (F = 4.26, P <0.01). Plasma BNP levels in children with grade I cardiac function have been significantly increased (t = 4.708, P <0.01), and heart function parameters LVEF and FS decreased not significantly. Different primary heart failure patients with plasma BNP no difference. Plasma BNP levels were negatively correlated with LVEF and FS (r = -0.568, -0.325, P <0.05, <0.001, respectively). Conclusions Plasma BNP levels in children with heart failure are significantly increased. As the degree of heart failure in children increases, the plasma BNP level increases significantly. Plasma BNP levels are more biochemical markers of cardiac function in children with heart failure.
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