成人先天性心脏病伴肺动脉高压患者超声心动图右心室功能指标和血浆N端脑利钠肽前体的相关性研究

Correlative study between plasma N-terminal pro-brain nirtie peptide and right ventricular function in adult congenital heart with pulmonary arterial hypertension

目的探讨韩国成人先天性心脏病伴肺动脉高压(PAH)患者超声心动图右心室Tei(RV-Tei)指数、右心室面积变化分数(RVFAC)和血浆N端脑利钠肽前体(NT-proBNP)之间的相关性。方法对2007年1月-2012年11月韩国三星首尔医院就诊的54例次成人先天性心脏病伴肺动脉高压患者超声心动图和血清学检查资料进行回顾性分析。结果 1RVFAC、PASP、RV-Tei指数和血浆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);2相关性分析:PASP与血浆NT-proBNP呈正相关(r=0.367,P<0.05),与RVFAC呈负相关(r=-0.755,P<0.05)。RVFAC与NT-proBNP呈负相关(r=-0.640,P<0.05)。RV-Tei与NT-proBNP、PASP、RVFAC均无相关性(r=-0.154、-0.227、-0.031,P>0.05)。结论 PAH程度不同成人先天性心脏病患者血浆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患者右心功能的评价指标。

[Objective] To investigate the correlation among plasma N-terminal pro-brain nirtie peptide （NT- proBNP） and right ventricular Tei （RVTei） and right ventricular fractional area change （RVFAC） in adult congenital heart with pulmonary hypertension from Korea. [Methods] From January 2007 to November 2012, 54 patients of e- chocardiography and serological examination data from Samsung Seoul hospital in Korea were retrospectively ana- lyzed. Patients were divided into two groups： 18 cases with 30 〈 PASP 〈 70 mmHg （mild to moderate group） and 36 cases with PASP≥70 mmHg （severe group）. [ Results ] ①RVFAC, PASP, RVTei index amt plasma concentration of NT-proBNP had a statistically significant difference （P 〈0.05） between the two groups. ②Correlation analysis： the plasma concentration of NT-proBNP had a positive correlation （r =0.367, P 〈0.05） with PASP; a negative correlation （r =-0.755, P 〈0.05） with RVFAC. RVFAC has a negative correlation （r =-0.755,-0.640, P 〈0.05） with PASP and the plasma concentrations of NT-proBNP. The RVTei had no cmTelation with the plasma concentration of NT-proB- NP, PASP, RVFAC （r =-0.154,-0.227,-0.031, P 〉0.05）. [Conclusions] Whether there are correlations between the plasma concentration of NT-proBNP and RVFAC depends on the degree of PAH. This suggests that the plasma con- centration of NT-proBNP and RVFAC can be used as evaluation of right ventrieular function in adult congenital heart with pulmonary hypertension.