【摘要】 目的:研究先天性心脏病(CHD)患者血清氨基末端脑钠肽前体(NT-p roBNP)浓度与肺动脉平均压(mPAP)的相关性。方法:62例行导管封堵治疗的CHD患者根据mPAP水平被分为四组:CHD不合并肺动脉高压(PAH)组(26例)、CHD合并轻度PAH组(17例)、CHD合并中度PAH组(12例)、CHD合并重度PAH组(7例),同期选择20例健康体检者作为健康对照组。比较各组介入封堵术前后24h及3个月时的血清NTpr oBNP浓度的变化并分析介入封堵术前NT-p roBNP浓度与mPAP的关系。结果:与健康对照组相比,术前各CHD组血清NT-p roBNP水平明显升高,且随着mPAP升高而显著升高[健康对照组(34.0±16.8)pg/ml比CHD无PAH组(68.0±20.2)pg/ml比轻度PAH组(116.7±43.5)pg/ml比中度PAH组(273.1±64.2)pg/ml比重度PAH组(326.5±50.2)pg/ml,P均<0.01];直线相关分析显示:62例CHD患者术前血清NT-p roBNP浓度与mPAP呈正相关(r=0.604,P=0.002)。各组术后24hNT-p roBNP浓度较术前升高,但只有CHD不合并PAH组有统计学差异[(98.9±22.1)pg/ml比(68.0±20.2)pg/ml,P<0.05],4组术后3个月NT-p roBNP浓度较术前均有显著降低(P均<0.01)。结论:先天性心脏病患者血清NT-p roBNP浓度随肺动脉压力升高而逐渐升高,可作为先心病患者肺动脉高压程度以及预后判断的一个指标。更多还原

【Abstract】 Objective:To study the correlation between serum N terminal pro brain natriuretic peptide(NT-proBNP)concentration and mean pulmonary arterial pressure(mPAP)in patients with congenital heart disease(CHD).Methods:Accordingto mPAP level,a total of 62 CHD patients undergoingtranscatheter closure were divided into non-pulmonary artery hy-pe rtension(PAH)CHD group(n=26),CHD+mild PAH group(n=17),CHD+moderate PAH group(n=12)and CHD+severe PAH group(n=7).Another 20 healthy subj ects in the same period were selected as healthy control group.The changes of serum NT-proBNP concentration was compared amongall groups before,24 h and three months after operation.Correlation between NT-proBNP concentration and mPAP was analy zed before transcatheter closure.Results:Compa red with healthy control group,there was significant rise in serum NT-proBNP level in all CHD groups before operation,and it significantly elevated alongwith mPAP increased[healthy control group(34.0±16.8)pg/ml vs.CHD non-PAH gr oup(68.0±20.2)pg/ml vs.mild PAH group(116.7±43.5)pg/ml vs.moderate PAH group(273.1±64.2)pg/ml vs.severe PAH group(326.5±50.2)pg/ml,P<0.01 all];linear correlation analy sis indicated that serum NT-proBNP concentration before operation was positively correlated with mPAP in62 CHD patients(r=0.604,P=0.002).On24 h after transcatheter closure,NT-proBNP concentration was significantly higher than before operation in all groups,but it possessed significant difference only in non-PAH CHD group[(98.9±22.1)pg/ml vs.(68.0±20.2)pg/ml,P<0.05].NTpr oBNP concentration was significantly lower than before operation in all CHD groups after three months(P<0.01 all).Conclusion:Serum NT-proBNP level rises alongwith pulmonary arterial pressure increased in patients with congenital heart disease,which could be used as an index j udgingseverity of pulmonary artery hy pe rtension and prognosis in these patients.更多还原