心力衰竭患儿血浆内皮素-1水平与心功能的关系

The relationship between endothelin-1 level and cardiac function in children with heart failure

目的:探讨心力衰竭患儿血浆内皮素-1(ET-1)水平与心功能的关系。方法:将心力衰竭患儿34例分成Ⅰ、Ⅱ、Ⅲ度心衰3个组,分别测定治疗前后血浆ET-1水平,并作超声心动图检查,观察ET-1水平与左室舒张末期容量指数(LVEDVI)及左室射血分数(LVEF)间的关系。同时,选20例正常健康儿童为对照组,作为小儿心力衰竭时血浆ET-1变化的对照。结果:(1)心力衰竭组血浆ET-1水平明显高于正常对照组,随着心力衰竭程度的加重,血浆ET-1水平逐渐增高,与心功能级别、LVEDVI呈正相关,与LVEF呈负相关。(2)心功能好转后血浆ET-1水平明显下降(P<0.05),LVEDVI明显下降(P<0.01),LVEF明显增高(P<0.01)。结论:心力衰竭时血浆ET-1水平明显增高,并且与心功能级别、LVEDVI、LVEF有较好的关联。

Objective ：To assess the relationship between endothelin-1 level and cardiac function in children with heart failure. Methods：34 children with heart failure were divided into Ⅰ,Ⅱand Ⅲ groups according to heart failure diagnostic criteria on Qingdao conference. Plasma ET-1 concentration was determined before and after treatment. All patients had echocardiographic study, including measurement of left ventricular end diastolic volume index（LVEDVI）, and left ventricular ejection fraction（LVEF）. The relation between plasma ET-1 and indices from echocardiography was studied. 20 healthy children were included in the control group, plasma ET-1 concentration was also determined. Results：（1 ）Plasma ET-1 concentration in children with congestive heart failure was significantly higher than that of the control group, and increased with the degree of heart failure, and was positively correlated with NYHA heart functional class and LVEDVI, and was negatively correlated with LVEF.（2）In children with congestive heart failure, plasma ET-1 concentration and LVEDVI post-treatment were significantly lower, and LVEF was significantly higher than that of pretherapy. Conclusions：Plasma ET-1 concentration is significantly higher in children with congestive heart failure, and has good correlation with NYHA heart functional class, LVEDVI and LVEF.