动脉导管未闭患儿手术前后血清脑利钠肽、肿瘤坏死因子-α和白细胞介素-10水平变化及临床检测价值研究

Changes of serum brain natriuretic peptide,tumor necrosis factor-α and interleukin-10 levels and their clinical value in children with patent ductus arteriosus before and after surgery

目的:探讨动脉导管未闭(PDA)患儿手术前后血清脑利钠肽(BNP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-10(IL-10)水平变化及临床检测价值。方法:选取PDA患儿124例为观察组,选取年龄相当的体检健康者124名为观察组。比较两组及观察组患儿手术前后心脏结构指标[左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及右心室舒张末期内径(RVEDD)]、Tei指数及血清BNP、TNF-α和IL-10水平。分析PDA患儿心脏结构指标、Tei指数与血清BNP、TNF-α和IL-10水平的相关性。分析血清BNP、TNF-α和IL-10对PDA的诊断价值。结果:观察组LAD、LVEDD、LVESD、RVEDD、Tei指数及血清BNP、TNF-α和IL-10水平高于对照组(均P<0.05)。术后3 d和术后3个月PDA患儿LAD、LVEDD、LVESD、RVEDD、Tei指数及血清BNP、TNF-α和IL-10水平低于术前,且术后3个月低于术后3 d(均P<0.05)。PDA患儿LAD、LVEDD、LVESD、RVEDD及Tei指数与血清BNP、TNF-α和IL-10水平呈正相关(均P<0.05)。血清BNP、TNF-α和IL-10对PDA均有一定诊断价值,三者联合的诊断价值更高(均P<0.05)。结论:PDA患儿心脏结构指标、Tei指数与血清BNP、TNF-α、IL-10水平均升高,术后以上指标得到一定改善,且血清BNP、TNF-α和IL-10三者联合检测对PDA的诊断价值较高。

Objective:To investigate the changes of serum brain natriuretic peptide(BNP),tumor necrosis factor-α(TNF-α)and interleukin-10(IL-10)levels and their clinical value in children with patent ductus arteriosus(PDA)before and after surgery.Methods: A total of 124 children with PDA were selected as the observation group,and 124 healthy subjects of the same age were selected as the observation group.The cardiac structural indexes(left atrial diameter[LAD],left ventricular end-diastolic diameter[LVEDD],left ventricular end-systolic diameter[LVESD] and right ventricular end-diastolic diameter[RVEDD]),Tei Index and serum levels of BNP,TNF-α and IL-10 were compared between the two groups and the observation group before and after operation.The correlation between cardiac structural indexes,Tei Index and serum levels of BNP,TNF-α and IL-10 in children with PDA was analyzed.The diagnostic value of serum BNP,TNF-α and IL-10 for PDA was analyzed.Results: LAD,LVEDD,LVESD,RVEDD,Tei Index and serum levels of BNP,TNF-α and IL-10 in observation group were higher than those in control group(all P<0.05).The levels of LAD,LVEDD,LVESD,RVEDD,Tei Index and serum BNP,TNF-α and IL-10 in children with PDA three days and three months after surgery were lower than those before surgery,and those three months after surgery were lower than three days after surgery(all P<0.05).LAD,LVEDD,LVESD,RVEDD and Tei Indexes were positively correlated with serum levels of BNP,TNF-α and IL-10(all P<0.05).Serum BNP,TNF-α and IL-10 had certain diagnostic value for PDA,and the combined value of the three was higher(all P<0.05).Conclusion:Cardiac structural indexes,Tei Index and serum levels of BNP,TNF-α and IL-10 are increased in children with PDA,and the above indexes are improved after surgery.The combined value of serum BNP,TNF-α and IL-10 is higher in the diagnosis of PDA.