肺动脉高压患儿血浆N端脑利钠肽前体和右心室Tei指数相关性研究

Correlative study between plasma N-terminal pro-brain natriuretic peptide and right ventricular Tei index in children with pulmonary arterial hypertension

目的探讨肺动脉高压(PAH)患儿血浆N端脑利钠肽前体(NT-proBNP)和右心室Tei(RVTei)指数和右心室面积变化分数(RVFAC)之间的相关性。方法对2007年1月至2012年11月韩国三星首尔医院就诊的38例次肺动脉高压患儿超声心动图和血清学检查资料进行回顾性分析。将肺动脉收缩压(PASP)>30mmHg～<70mmHg(1mmHg=0.133kPa)的16例次(轻中度组)与≥70mmHg的22例次(重度组)患儿进行分组分析。结果 (1)RVFAC、PASP和血浆NT-proBNP浓度在轻中度PAH组和重度PAH组之间差异有统计学意义(P<0.05)。RVTei指数在轻中度PAH组和重度PAH组之间差异无统计学意义(P>0.05)。(2)相关性分析:血浆NT-proBNP浓度与PASP呈正相关(r=0.544,P<0.05),与RVFAC呈负相关(r=-0.767,P<0.05)。RVFAC与PASP、血浆NT-proBNP浓度呈负相关(r=-0.711、-0.767,P<0.05)。RVTei与血浆NT-proBNP浓度、PASP、RVFAC均无相关性(r=-0.041、-0.048、0.016,P>0.05)。结论 PAH程度不同患儿血浆NT-proBNP浓度与RVFAC具有相关性。提示血浆NT-proBNP浓度与RVFAC可作为PAH患儿右心功能的评价指标。

Objective To investigate the correlation among plasma N-terminal pro-brain natriuretic peptide （NT-proB- NP） and right ventricular Tel （RVTei） and right ventricular fractional area change （RVFAC） in children with pulmo- nary hypertension. Methods From January 2007 to November 2012, echocardiography and serological examination da- ta of 38 patients from Samsung Seoul Hospital in Korea were retrospectively analyzed. Patients were divided into two groups ： 16 cases with 30 〈 PASP 〈 70mmHg （mild to moderate） and 22 cases with PASP≥70mmHg （severe）. Results （1） RVFAC, PASP and plasma concentration of NT-proBNP had a statistically significant difference （P 〈 0.05） be- tween mild to moderate PAH group and severe PAH group . RVTei index had no difference between the two groups （P 〉 0.05 ）. （2） Correlation analysis ： the plasma concentration of NT-proBNP had a positive correlation （r = 0.544, P 〈 0.05 ） with PASP, a negative correlation （r =-0.767, P〈0.05） with RVFAC; RVFAC had a negative correlation （r = -0.711,-0.767, P 〈 0.05） with PASP and the plasma concentrations of NT-proBNP; the RVTei had no correlation with the plasma concentration of NT-proBNP, PASP or RVFAC （r = -0.041,-0.048, 0.016, P 〉 0.05）. Conclusion Whether there are correlations between the plasma concentration of NT-proBNP and RVFAC depends on the degree of PAH. This suggests that the plasma concentration of NT-proBNP and RVFAC can be used as evaluation of right ven- tricular function in children with pulmonary hypertension.