先天性心脏病并肺动脉高压患儿血清结缔组织生长因子的表达及意义

Expression of serum connective tissue growth factor in children with congenital heart disease and pulmonary artery hypertension and its significance

目的 探讨血清结缔组织生长因子（CTGF）在CHD并肺动脉高压（PAH）患儿中的表达和意义。方法 选择2009年5月至2012年2月在沪州医学院附属医院住院手术治疗的CHD患儿50例，均通过右心导管检查测肺动脉压力，根据肺动脉收缩压（PASP）水平分为无 PAH 组（PASP 〈3.99 kPa）21例、轻度 PAH 组（3.99 kPa≤PASP〈6.65 kPa）17例和中重度PAH 组（PASP≥6.65 kPa）12例。ELISA 法测定 CTGF和转化生长因子-β 1（TGF-β 1）水平，分析二者及其与PASP的关系。结果 与无PAH 组比较，轻度和中重度 PAH 组血清 CTGF和TGF-β 1水平均升高（P均〈0.01）；中重度 PAH 组血清 CTGF和 TGF-β 1水平均较轻度 PAH 组升高（P 均〈0.01）；轻度PAH 组和中重度PAH 组血清CTGF水平与PASP均呈正相关（r=0.828、0.849，P均〈0.01）；轻度PAH 组和中重度PAH 组血清CTGF水平与TGF-β 1均呈正相关（r=0.714、0.713，P均〈0.01）；轻度和中重度 PAH 组血清TGF-β 1水平与PASP均呈正相关（r=0.623、0.639，P均〈0.05）。结论 血清CTGF水平在CHD 并 PAH 患儿中升高，可能是CHD并PAH 形成和发展的重要因素。

Objective To investigate the expression of serum connective tissue growth factor（CTGF） in con-genital heart disease（CHD） with pulmonary artery hypertension （PAH） and its significance. Methods Fifty children with CHD in the Affiliated Hospital of Luzhou Medical College from May 2009 to Feb. 2012 were selected in the study. Pulmonary artery systolic pressure （PASP） were measured by right heart catheterization. They were divided into 3 groups according to PASP levels as follows：normal PAH group（ PASP 〈 3.99 kPa, n = 21 ）, mild PAH group（ 3.99 kPa≤ PASP 〈 6.65 kPa, n = 17 ）, moderate or severe PAH group （ PASP/〉 6.65 kPa, n = 12 ） ; serum CTGF and transfor-ming growth factor-β1（ TGF-β1 ） were detected by using double-antibody sandwich enzyme linked immunosorbent as-say. The relationship among the 3 groups and their PASP were analyzed. Results In comparison to normal PAH group, serum CTGF and TGF-β1 were significantly elevated in mild PAH group and moderate or severe PAH group （ all P 〈 0. 01 ） ;compared with mild PAH group, serum CTGF and TGF-β1 were higher in moderate or severe PAH group（ all P 〈 0. 01 ） ;CTGF levels were positive correlated with PASP both in mild PAH group and moderate or severe PAH group（ r = 0. 828,0.849,all P 〈 0.01 ）;there were positive correlations between CTGF and TGF-β1 level in mild PAH group and moderate or severe PAH group （r = 0. 714,0. 713, all P 〈 0. 01 ） ;there were positive correlations between TGF-β1 and PASP in mild PAH group and moderate or severe PAH group （ r = 0. 623,0. 639, all P 〈 0.05 ）. Conclusions Serum CTGF levels are elevated in children with CHD and PAH, which may be an important factor for the formation and develop-ment of CHD with PAH.