婴幼儿肺炎合并心力衰竭时血浆尾加压素Ⅱ的变化及其与心功能关系研究

Study of the correlation of plasma U Ⅱ levels and heart function in infants with pneumonia complicated congestive heart failure

目的探讨肺炎并心力衰竭时血浆尾加压素Ⅱ(UⅡ)的变化及其与心功能的关系。方法肺炎并心衰组、普通肺炎组、健康对照组各30例,放射免疫法检测各组血浆UⅡ含量,其中肺炎并心衰组有20例治疗后复测血浆UⅡ含量;多普勒超声心动图测定患儿的左室射血分数(EF)、左室短轴缩短百分率(FS)、主动脉峰值流速(PFVA)、肺动脉峰值流速(PFVP)以反映心功能变化。结果肺炎并心衰组与普通肺炎组及健康对照组比较,血浆UⅡ含量显著升高,EF、FS、PFVA、PFVP均显著下降(P<0.05),心衰治疗后血浆UⅡ含量下降显著(P<0.05),肺炎并心衰组治疗前血浆UⅡ与EF、FS、PFVA、PFVP呈显著负相关。结论UⅡ参与肺炎并心衰的病理过程,动态检测UⅡ含量有助于判断肺炎并心衰的病情及预后。

Objectives To investigate the changes of plasma U Ⅱ levels and the relationship between the changes of plasma U Ⅱ and heart function in the infant pneumonia complicated congestive heart failure （CHF） . Methods These infants were divided into three groups： infants with pneumonia complicated CHF, infants with pneumonia, and normal infants. Each group had 30 cases. Plasma U Ⅱ levels were determined with radioimmunoassay in the three groups. And determined again in 20 infants with pneumonia complicated CHF after treatment. Ejection fraction （EF）, fractional shortening（FS） , peak flow velocity of aorta （PFVA）and peak flow velocity of pulmonary artery （PFVP） were measured with Doppler ultrasonography to reflect the changes of heart function. Results In comparison with the infants with pneumonia and the normal infants, the plasma U Ⅱ levels were significantly higher, while the EF, FS, PFVA, PFVP were significantly decreased in the infants with pneumonia complicated CHF （P 〈 0.05） . And, after treatment, the plasma U Ⅱ levels were significantly decreased in this group （P 〈 0.05）, with negative relationahip between U Ⅱ and EF, FS, PFVA, PFVP. Conclusions Plasma U Ⅱ plays a role in the pathophysiological process of pneumonia complicated CHF and monitoring the dynamic changes could predict the degree of the pneumonia complicated CHF.