先天性心脏病患儿心功能水平与血清脑利钠肽水平的相关性研究

目的观察室间隔缺损先天性心脏病患儿心功能水平、心衰情况与血清脑利钠肽（BNP）水平变化,评价二者之间的相关性。方法选取先天性心脏病室间隔缺损患儿49例,根据患儿超声心动图肺体循环血流比大小分为大分流组和小分流组,并根据患儿症状体征分为无心衰症状组和有心衰症状组;同时选取无心功能损害患儿20例为对照组。同时采血检测各组患儿血清BNP水平,比较各组患儿血清BNP水平差异并分析患儿血清BNP水平与心衰、分流量之间的相关性。结果大、小分流组患儿血清BNP水平均有升高,大分流组患儿血清BNP水平与小分流组及对照组相比,差异均有统计学意义（P〈0.05或P〈0.01）;小分流组患儿血清BNP水平与对照组相比,差异有统计学意义（P〈0.05）。心衰情况与患儿血清BNP水平呈正相关（r=1.512,P=0.037）;患儿心脏分流量（LVEF、LVSF）与血BNP水平均存正相关（r=0.395、P=0.010,r=0.128、P=0.023）。结论血清BNP水平与先天性室间隔缺损心脏病患儿病情严重程度相关,血清BNP水平可作为评价室间隔缺损先天性心脏病患儿心功能水平的可靠指标。

Relationship between Cardiac Function and Serum Brain Natriuretic Peptide Levels in Children with Congenital Heart Disease

Objective To investigate the relationship of serum brain natriuretic peptide（BNP） levels with cardiac function and heart failure in children with left-to-right shunt congenital heart disease（CHD）.Methods Forty-nine children with CHD were divided into high discharge group and low discharge group.At the same time,these CHD children were divided into heart failure group and non-failure group according to symptoms and signs.Furthermore,20 children without cardiac dysfunction were enrolled as a control group.The levels of serum BNP were measured and their relationships with heart failure and shunted blood flow were analyzed.Results The levels of serum BNP in high discharge group were significantly higher than in both low discharge group and control group（P0.05 or P0.01,respectively）.Moreover,serum BNP levels in low discharge group were higher than in control group（P0.05）.The levels of serum BNP were positively correlated with heart failure（r=1.512,P=0.037）and shunted blood flow（r=0.395,P=0.010 vs LVEF,r=0.128,P=0.023 vs LVSF）.Conclusion The levels of serum BNP are correlated with the severity of cardiac injury,and hence they can be used to evaluate cardiac function in children with CHD.