先天性心脏病患者血NT-proBNP浓度与肺动脉高压和导管封堵术的相关性（英文）

Correlation between serum NT-proBNP concentration and pulmonary artery hypertension and change of NT-proBNP concentration after transcatheter closure in patients with congenital heart disease

目的:研究先天性心脏病(CHD)患者血清氨基末端脑钠肽前体(NT-p roBNP)浓度与肺动脉平均压(mPAP)的相关性。方法:62例行导管封堵治疗的CHD患者根据mPAP水平被分为四组:CHD不合并肺动脉高压(PAH)组(26例)、CHD合并轻度PAH组(17例)、CHD合并中度PAH组(12例)、CHD合并重度PAH组(7例),同期选择20例健康体检者作为健康对照组。比较各组介入封堵术前后24h及3个月时的血清NTpr oBNP浓度的变化并分析介入封堵术前NT-p roBNP浓度与mPAP的关系。结果:与健康对照组相比,术前各CHD组血清NT-p roBNP水平明显升高,且随着mPAP升高而显著升高[健康对照组(34.0±16.8)pg/ml比CHD无PAH组(68.0±20.2)pg/ml比轻度PAH组(116.7±43.5)pg/ml比中度PAH组(273.1±64.2)pg/ml比重度PAH组(326.5±50.2)pg/ml,P均<0.01];直线相关分析显示:62例CHD患者术前血清NT-p roBNP浓度与mPAP呈正相关(r=0.604,P=0.002)。各组术后24hNT-p roBNP浓度较术前升高,但只有CHD不合并PAH组有统计学差异[(98.9±22.1)pg/ml比(68.0±20.2)pg/ml,P<0.05],4组术后3个月NT-p roBNP浓度较术前均有显著降低(P均<0.01)。结论:先天性心脏病患者血清NT-p roBNP浓度随肺动脉压力升高而逐渐升高,可作为先心病患者肺动脉高压程度以及预后判断的一个指标。

Objective： To study the correlation between serum N terminal pro brain natriuretic peptide （NT-proBNP） concen- tration and mean pulmonary arterial pressure （mPAP） in patients with congenital heart disease （CHD）. Methods.. Accord- ing to mPAP level, a total of 62 CHD patients undergoing transcatheter closure were divided into non- pulmonary artery hy- pertension （PAH） CHD group （ n = 26 ）, CHD ± mild PAIl group （ n = 17 ）, CHD ± moderate PAIl group （ n = 12 ） and CHD±severe PAH group （n=7）. Another 20 healthy subjects in the same period were selected as healthy control group. The changes of serum NT-proBNP concentration was compared among all groups before, 24h and three months after opera- tion. Correlation between NT-proBNP concentration and mPAP was analyzed before transcatheter closure. Results.. Com- pared with healthy control group, there was significant rise in serum NT-proBNP level in all CHD groups before operation, and it significantly elevated along with mPAP increased [healthy control group （34.0 ±16. 8） pg/ml vs. CHD non-PAH group （68.0~20. 2） pg/ml vs. mild PAH group （116.7±43.5） pg/ml vs. moderate PAH group （273.1±64.2） pg/ml vs. severe PAH group （326.5 ± 50. 2） pg/mh P〈0.01 all]; linear correlation analysis indicated that serum NT-proBNP con- centration before operation was positively correlated with mPAP in 62 CHD patients （r = 0. 604, P= 0. 002）. On 24h after transcatheter closure, NT-proBNP concentration was significantly higher than before operation in all groups, but it pos- sessed significant difference only in non-PAH CHD group [（98. 9±22.1） pg/ml vs. （68. 0±20.2） pg/ml, P〈0.05]. NT- proBNP concentration was significantly lower than before operation in all CHD groups after three months （P〈0.01 all）. Conclusion.. Serum NT-proBNP level rises along with pulmonary arterial pressure increased in patients with congenital heart disease, which could be used as an index judging severity of pulmonary artery hypertension and prognosis in these patients.