摘要
目的 探讨脑利钠肽(BNP)在VSD合并心力衰竭患儿心功能评估中的价值及其改变发生的机理。方 法 15例VSD合并心力衰竭的患儿,分为Qr／Qs≥3.0和Qr／Qs<3.0两组,分别测定手术前后血浆BNP,观察 BNP与Qp／Qs、Pp／Ps及超声心动图测得的反映心室功能及负荷的心功能指标间的关系。结果 ①手术后BNP较 手术前明显降低,下降百分比与术后时间有正相关趋势;②BNP与Qr／Qs呈正相关,Qp／Qs≥3.0组明显高于Qp／Qs <3.0组,而BNP与Pp／Ps间无明显相关性;③BNP与超声心动图测得的LVEDVI、LVESWS呈正相关,与LVEF、 LVFS、mVcFc、Con无相关性。结论 ①BNP与反映心室容量及压力负荷的指标间呈正相关,可反映心室负荷的改 变,可用于VSD患儿心功能的评估;②容量及压力负荷过重是造成VSD合并心力衰竭患儿BNP水平升高的主要 原因。
Objective The aim of this study was to assess the value of plasma BNP measurement for evaluating cardiac function in ventricular septal defect children with congestive heart failure, and to find the mechanism of the change of BNP. Methods Fifteen children with VSD and congestive heart failure were divided into two groups according to Qp/Qs from catheter: Qp/Qs≥3.0 and Qp/Qs<3.0. Plasma BNP concentration was determined before and after operation. All subjects underwent catheter and echocardiogra phy.The relation between plasma BNP concentration and indices from catheter and echocardiography were studied. Results (1)Plasma BNP concentration after operation was significantly lower than that of preope ration, and the percentage of declination was positively correlated with the time after operation. (2)Plasma BNP concentration was positively correlated with Qp/Qs, and the concentration of the group of Qp/Qs≥3.0 was higher than that of the group of Qp/Qs<3.0. (3)Plasma BNP concentration was positively correlated with LVEDVI and LVESWS from echocardiography, but not correlated with LVEF, LVFS, mVcFc, Con. Conclusions (1)In patients with VSD and congestive heart failure, plasma BNP concentration can reflect the change of ventricular load, and can be used for evaluating cardiac function.(2)The leading cause of high plasma BNP concentration in VSD children with congestive heart failure was overload of volume and afterload.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2004年第3期139-142,共4页
Journal of Clinical Pediatrics
