摘要
目的观察成人先天性房间隔缺损(ASD)患者用国产Amplatzer封堵器介入治疗前后的神经内分泌因子及心指数(CI)的变化,探讨成人ASD患者神经内分泌的激活状况及与心功能的关系。方法检测30例成人ASD患者的心房钠尿肽(ANP)、脑钠尿肽(BNP)、内皮素-1(ET)及CI在介入治疗前、术后24 h、1个月、3个月、6个月的动态变化,另选取年龄及性别与之相匹配的正常体检成人30例作为对照组。结果成人ASD术前血循环中的ET(146±36)ng/L、ANP(148±30)ng/L、BNP(357±61)ng/L与对照组比较显著增高(均P<0.01),在介入治疗24 h后,均开始下降,至6个月基本下降至正常水平(P<0.01);术前的CI与对照组比较明显降低(P<0.05),在介入治疗24 h后,开始上升,至6个月基本恢复至正常水平(P<0.01)。血浆ANP、BNP和ET浓度与CI之间呈明显的负相关(相关系数分别是r=-0.56,P<0.01;r=-0.58,P<0.01;r=-0.45,P<0.05)。结论成人ASD存在神经内分泌的激活,并与CI呈负相关关系。介入治疗后其神经内分泌的功能及CI逐渐恢复正常。
AIM To detect the changes of neuroendocrine factor and cardiac index （CI） after interventional therapy, to explore whether neurohormonal activation exists in adults with congenital heart disease and to study the relationship between neuroendocrine factor and heart function. METHODS Concentrations of atrial natriuretic peptide （ ANP）, brain natriuretic peptide （BNP） and endothelin （ ET）, and CI were continuously detected in 30 adults with congenital heart disease, before interventional therapy and 24 h, 1 month, 3 months and 6 months after interventional therapy. Thirty cases of routine physical check-up were enrolled in the control group. RESULTS The adults with congenital heart disease had elevated levels of ET （ 146 ±36 vs 62 ± 10）ng/L, ANP （ 148 ±30 vs 81 ± 16）ng/L, BNP （357 ±61 vs 14 ± 6） ng/L, before interventional therapy （ all P 〈 0.01 ）, which descended after interventional therapy and nearly recovered to normal level at the 6th month. In contrast, there were lower levels of CI [ 3.38 ± 0.29 vs 5.31 ± 0.21 ] L/（ min ·m^2 ）, which went up after interventional therapy and nearly recovered to normal level at the 6th month. CONCLUSION There is neurohormonal activation in adult congenital heart disease, which is negatively related to CI. The neuroendocrine function and CI gradually return to normal after interventional therapy.
出处
《心脏杂志》
CAS
2007年第1期51-52,56,共3页
Chinese Heart Journal
基金
广西科技攻关项目资助(桂科攻No.0472002-30)
关键词
房间隔缺损
先天性
介入治疗
神经内分泌因子
心脏指数
heart defect, congenital
interventional therapy
neuroendocrine factor
cardiac index
