肺炎并心力衰竭患儿血浆尾加压素Ⅱ变化的临床研究

Clinical study on changes of plasma urotensin Ⅱ levels in children with pneumonia combined with heart failure

目的:探讨血浆尾加压素Ⅱ(UⅡ)在小儿肺炎并心力衰竭时的变化及其临床意义。方法:选择肺炎并心衰组、普通肺炎组、健康对照组各30例,采用放射免疫法检测各组血浆UⅡ含量,并检测心肌肌钙蛋白I(cTnI)及肌酸激酶心肌同工酶(CK-MB)。其中肺炎并心衰组有20例治疗后复测UⅡ、cTnI及CK-MB,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)反映心功能变化的指标。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、cTnI及CK-MB显著升高,EF、FS均显著下降(P<0.05),心衰治疗后血浆UⅡ含量、cTnI及CK-MB下降显著(P<0.05),肺炎并心衰组治疗前血浆UⅡ与EF、FS呈显著负相关,与cTnI、CK-MB呈显著正相关。结论:UⅡ参与肺炎并心衰的病理生理过程,血浆尾加压素Ⅱ的含量可反映心功能的程度,肺炎并心力衰竭时血浆尾加压素Ⅱ的升高与心肌损害有关。

Objective：To explore the changes of plasma urotensin Ⅱ levels in children with pneumonia combined with heart failure and its clinical significance.Methods：30 children with pneumonia combined with heart failure,30 children with common pneumonia and 30 healthy children were selected,radioimmunoassay was used to detect the plasma urotensin Ⅱ levels in the three groups,the levels of cardiac troponin I（cTnI） and creatinine kinase isoenzyme（CK-MB） were detected;20 children in pneumonia combined with heart failure group received repetition measurement of urotensin Ⅱ,cTnI and CK-MB after treatment;the indicators which reflected the changes of heart function including left ventricular ejection fraction（EF） and fractional shortening of left ventricular short axis（FS） were measured by Doppler ultrasonic cardiogram.Results：Compared with common pneumonia group and control group,the plasma content of urotensin Ⅱ and the levels of cTnI and CK-MB in pneumonia combined with heart failure group increased significantly,EF and FS decreased significantly（P〈0.05）;after treatment,the plasma content of urotensin Ⅱ and the levels of cTnI and CK-MB decreased significantly（P〈0.05）;before treatment,there was negative correlation between plasma urotensin Ⅱ and EF,FS in pneumonia combined with heart failure group,and there was positive correlation between plasma urotensin Ⅱ and cTnI,CK-MB.Conclusion：Urotensin Ⅱ participates in the pathophysiological process of pneumonia combined with heart failure,the content of plasma urotensin Ⅱ may reflect the degree of cardiac function,the increase of plasma urotensin Ⅱ in patients with pneumonia combined with heart failure is related to myocardial damage.