先天性心脏病患儿脑利钠肽水平的临床研究

Clinical Research on the Brain Natriuretic Peptide Level in Children with Congenital Heart Disease

目的探讨先天性心脏病患儿血浆脑利钠肽（BNP）水平与心功能的关系及其临床意义。方法回顾性分析70例先心病患儿的临床资料,根据先天性心脏病的类型分为两组：A组为左向右分流型先心病,B组为发绀型先心病。常见左向右分流型先心病又按心功能分级及肺动脉高压情况分为2类。用化学发光免疫分析法测定血浆BNP水平。同时选取30例正常儿童作为对照组。结果⑴除法洛四联症外,其他类型的先心病患儿血浆BNP水平均高于正常对照组；⑵常见左向右分流型先心病患儿心功能Ⅲ～Ⅳ级合并肺动脉高压者与心功能Ⅰ～Ⅱ级无肺动脉高压者,血浆BNP水平存在明显差异（P〈0.01）。结论血浆BNP水平不仅与心功能存在明显正相关,而且对判断肺循环血流量具有重要意义。

OBJECTIVE To explore the clinical significance of and relationship between plasma Brain Natriuretic Peptide（BNP） and cardiac function in children with congenital heart disease. METHODS By retrospective analyzing on the clinical data from 70 children with congenital heart disease, 2 groups were divided based on the types of congenital heart disease： ⑴ left to right shunt congenital heart disease; ⑵ congenital heart disease with cyanosis. Based on the cardiac function grading and the situation of pulmonary hypertension, left to right shunt congenital heart disease could be further classified into 2 types. Plasma BNP could be determined by chemiluminescence immunoassay assay. RESULTS ⑴ Excluding the patients with tetralogy of fallot, the plasma BNP levels in the children with other types of congenital heart disease were higher than the normal control; ⑵ in children with left to right shunt congenital heart disease, who were cardiac function III-IV combined with pulmonary hypertension and cardiac function I-II without pulmonary hypertension, the plasma BNP levels showed significant differences（P0.01）. CONCLUSIONS The plasma BNP level was significant positive correlated to the cardiac function, in addition, had important significance on determining the circulating blood volume.