先天性心脏病合并肺动脉高压患者血清B型尿钠肽、血管内皮生长因子及高敏C反应蛋白水平变化的研究

Study of the changes of serum BNP,VEGF,and hs-CRP in patients with congenital heart disease combined with pulmonary arterial hypertension

目的探讨血清B型尿钠肽(BNP)、血管内皮生长因子(VEGF)、高敏C反应蛋白(hs-CRP)水平与先天性心脏病(简称先心病)合并肺动脉高压患者肺动脉压的关系。方法体肺分流性先心病41例,正常对照组20例。先心病患者分为无肺动脉高压组16例,轻中度肺动脉高压组13例和重度肺动脉高压组12例。应用酶联免疫吸附法(ELISA)测定患者血清标本BNP、VEGF及hs-CRP水平,并探讨其与肺动脉压相关性。结果先心病患者血清BNP、VEGF及hs-CRP水平较对照组明显升高(P均<0.05),并且BNP、VEGF水平与肺动脉压力呈正相关(r=0.754,P<0.001;r=0.641,P<0.001)。结论先心病早期虽未发生肺动脉高压,但已有炎症的激活,肺血管的重构。血清BNP、VEGF水平对于先心病合并肺动脉高压患者肺动脉压的评估有一定意义及临床价值。

Objective To investigate the serum levels of brain natriuretic peptide（BNP）,vascular endothelial growth factor（VEGF）,high-sensitivity C-reactive protein（hs-CRP）in the patients with congenital heart disease combined with pulmonary arterial hypertension.Methods 41 cases of congenital heart disease and 20 cases of normal control group were involved in the research.The patients with congenital heart disease were divided into 16 cases of non-pulmonary arterial hypertension group,13 cases of mild to moderate pulmonary arterial hypertension group and 12 cases of severe pulmonary arterial hypertension group.The serum BNP,VEGF and hs-CRP were detected by enzyme-linked immunosorbent assay（ELISA）,and the relationship between them and mean pulmonary arterial pressure were analyzed.Results The level of BNP,VEGF and hs-CRP in patients with congenital heart disease were significantly higher than normal group,and the pulmonary arterial pressure was positively correlated with the level of BNP and VEGF.Conclusions Pulmonary hypertension has not yet occurred in patients with congenital heart disease,but there are inflammatory response and pulmonary vascular remodeling.The level of serum BNP and VEGF can assess the degree of pulmonary arterial hypertension in patients with congenital heart disease combined with pulmonary arterial hypertension.