摘要
目的了解小儿心衰时神经激素改变及其与心功能的关系,同时研究神经激素改变能否作为小儿心衰定量诊断指标。方法23例心衰患儿测定血清肾素(PRA)、血管紧张素II(AngII)、醛固酮(ALD)、心钠素(ANF)和24h尿中肾上腺素(EN)、去甲肾上腺素(NEN)、多巴胺(DA);20例心衰患儿的心脏指数(CI)、射血分数(EF)与20名同年龄、同性别正常小儿的上述指标做对比;分析PRA、AngII、ALD、ANF、EN、NEN、DA与CI、EF之间的关系。结果心衰患儿血清中PRA、AngII、ALD、ANF升高,24h尿中EN、NEN、DA升高,CI、EF下降;心衰患儿PRA、AngII、ALD、ANF升高程度NYHA心功能IV级高于III级,血清中PRA、AngII、ALD、ANF以及尿中EN、NEN、DA与CI、EF呈直线负相关,相关性最好的是ANF与CI、EF;血清ANF与CI相关系数为-0.74,P<0.01;血清ANF与EF亦呈直线负相关,相关系数为-0.71,P<0.001。结论血清中PRA、AngII、ALD、ANF与尿中EN、NEN、DA在小儿心衰时增高;血清中PRA、AngII、ALD、ANF以及尿中EN、NEN、DA与CI、EF呈直线负相关,以ANF与CI、EF相关性最好;血清中ANF可作为小儿心衰定量诊断指标之一。
Objective To investigate the neurohormoral changes and its relation to heart function in pediatric heart failure whether or not the neurohormoral changes could be a quantilative diagnostic critetia of pediatric heart failure.Methods Serum PRA,AngII,ALD,ANF of 23 children with heart failure,and urine EN,NEN ,DA of 20 children with heart failure and EF,CI of 23 children with heart failure were measured.The items mentioned above of 20 normal children were also measured in the same time.The relationship between PRA,AngII,ALD,ANF,EN,NEN ,DA and EF,CI were analyzed.Results PRA,AngII,ALD,ANF in serum and EN,NEN,DA in urine of 24 hours increased and CI and EF decreased in children with heart failure.The increasing value of PRA,AngII,ALD and ANF were more prominent in NYHA heart function 4th degree than in NYHA heart function 3rd degree.There were linear negative relation between PRA,AngII,ALD,ANF in serum,EN,NEN ,DA in urine of 24 hours and EF,CI.There was best negative relation between ANF and CI,EF.The relation between ANF and CI r=-0.74,P<0.01; the relation between ANF and EF r=-0.71,P<0.001.Conclusion PRA,AngII,ALD,ANF in serum and EN,NEN,DA in urine increased in children with heart failure.PRA,AngII were linear negative related to CI and EF.There were best negative relation between ANF and EF,CI.ANF could be a quantitative diagnostic criteria for pediatric heart falure.
出处
《小儿急救医学》
2005年第3期180-182,共3页
Pediatric Emergency Medicine
关键词
小儿心衰
神经激素
心功能
Pediatric heart falure
Neurohormonal
Heart function
