血清氨基末端脑钠肽在先天性心脏病并心力衰竭患儿中的临床意义

Clinical significance of serum amino-terminal pro-brain natriuretic peptide in children with congenital heart disease and heart failure

脑钠肽也称B型利钠肽,其合成及分泌主要在心室,刺激BNP基因表达及分泌增高的因素主要为物理机械牵张,即心房和心室肌细胞感受压力和容量负荷后分泌[1]。先天性心脏病（先心病）患儿心脏彩超测量结果因受心脏结构、心内分流、瓣膜反流等因素影响,左室射血分数（LVEF）、左室短轴缩短（LVFS）有时很难准确反映心功能。本研究通过分析先心病并心力衰竭（心衰）患儿血清N末端B型脑钠肽（NT-proBNP）水平的改变及其与病情严重程度、与LVEF及LVFS的关系，探讨血清NT-proBNP水平在先心病合并心衰的临床诊断及心功能评估中的价值。

This study was designed to observe the change of the serum amino-terminal pro-brain natriuretic peptide （NT-proBNP） levels in patients with congenital heart disease （CHD） and heart failure （HF）, and ana- lyzed the value of the NT-proBNP in cardiac function assessment in these patients. The results showed that serum NT-proBNP levels were significantly increased in turn in CHD＋ HF groups that divided into cardiac function I , Ⅱ , Ⅲ, Ⅳ levels （P〈0.05）. And the serum NT-proBNP levels in CHD＋HF groups were significantly higher than those in healthy control group （P〈0.01）. Furthermore, the serum NT-proBNP levels in CHD＋ HF groups were negatively correlated with LVEF and LVFS （r=- 0. 563, -0. 227,P〈0.05）.