【摘要】 目的:探讨血浆脑钠肽(BNP)及Tei指数在左向右分流型先天性心脏病(CHD)患儿中的变化及其对心功能评价的价值。方法:44例左向右分流型CHD患儿按心室容量负荷分为左心型组及右心型组,对照组20例。应用ELISA方法测定血浆BNP浓度;超声心动图测量左室舒张末期内径(LVEDD)、右室舒张末期内径(RVEDD)、肺循环血流量/体循环血流量(Qp/Qs)、左室射血分数(LVEF)及左室Tei指数,进行比较;22例CHD患儿接受手术治疗,手术前后进行比较。结果:①与对照组比较,左心型和右心型CHD组血浆BNP浓度均显著增高(P<0.001),左室Tei指数亦增大(P<0.05);②左心型和右心型CHD组血浆BNP浓度分别与LVEDD和RVEDD、Qp/Qs、左室Tei指数呈正相关;③手术后CHD患儿血浆BNP浓度和左室Tei指数均低于术前(P<0.01)。结论:血浆BNP水平及Tei指数是评价左向右分流型CHD患儿心功能的有效、敏感指标,可为临床诊治工作和疗效判断提供参考。更多还原

【Abstract】 Objective:To investigate the changes of plasma brain natriuretic peptide(BNP) and Tei index in children with left to right congenital heart defects(CHD),as well as the value in functional assessment in CHD.Methods:The plasma concentrations of BNP were obtained using enzyme immunoassay from 44 children with left to right CHD,who were divided into two groups according to their ventricular volume load.Among them,22 children were operated,and the plasma concentrations of BNP were obtained after operation again.Left ventricular Tei index,LVEDD,RVEDD,Qp/Qs and LVEF were also calculated.20 normal subjects were studied as controls.Results:①Compared with control values,BNP concentrations were significantly elevated in the left and the right ventricular overload CHD groups(P<0.001).Tei indexes were also significantly elevated in these two CHD groups(P<0.05).②The BNP levels significantly positively correlated with LVEDD,Qp/Qs and Tei index in the left ventricular overload CHD,and RVEDD,Qp/Qs and Tei index in the right ventricular overload CHD.③BNP concentration and Tei index after operation were all significantly lower than that of pre-operation in 22 children operated(P<0.01).Conclusion:Plasma BNP concentration and Tei index should be the useful and sensitive indexes in functional assessment for clinical diagnosis,treatment and curative effect in left to right CHD.更多还原