介入封堵并药物干预对先心病并肺动脉高压患儿BNP及ET水平的影响

Influence of transcatheter closure combined drug intervention on BNP and vascular vascular endothelium levels in children with CHD complicated pulmonary artery hypertension

目的：研究介入封堵术联合药物干预对先天性心脏病合并肺动脉高压（PAH）患儿脑钠肽（BNP）及血管内皮素（ET）水平的影响。方法：选择2011年3月～2013年5月期间我院收治的先天性心脏病合并 PAH 患儿70例，采用随机数字表法分为给予介入封堵术联合药物干预组（联合治疗组）和仅给予介入封堵治疗的对照组（介入封堵对照组），各35例。观察各组细胞因子水平及心功能指标，并进行比较。结果：治疗后与介入封堵对照组比较，联合治疗组患者 BNP [（352.7±56.2）ng／L 比（194.5±25.2）ng／L]、血管 ET [（68.4±8.4）ng／L 比（37.5±5.2）ng／L]水平均明显降低（P ＜0.01），左室舒张早期充盈峰速度[E 峰值，（63.7±6.9）cm／s 比（71.7±7.4）cm／s]、左室舒张早期／晚期充盈峰速度比值[E／A 比值，（1.10±0.13）比（1.34±0.16）]、左室射血分数[LVEF，（62.3±7.6）％比（66.4±7.1）％]、左室舒张末期内径[LVEDd，（48.9±5.7）mm 比（54.1±5.8）mm]均明显升高（P ＜0.05或＜0.01）。结论：介入封堵术联合药物干预有助于降低脑钠肽及血管内皮素的含量、改善心功能，具有积极的临床应用价值。

Objective：To study the influence of transcatheter closure combined drug intervention on levels of brain na-triuretic peptide （BNP）and vascular endothelium （ET）in children with congenital heart disease （CHD）complicated pulmonary artery hypertension （PAH）.Methods：A total of 70 CHD ＋ PAH children from Mar 2011 to May 2013 in our hospital were enrolled.According to random number table,they were equally divided into transcatheter clo-sure combined drug intervention group （combined treatment group）and transcatheter closure control group （only re-ceived transcatheter closure therapy）.Cytokine levels and heart function indexes were observed and compared be-tween two groups.Results：Compared with transcatheter closure control group after treatment,there were signifi-cant reductions in levels of BNP [（352.7±56.2）ng/L vs.（194.5±25.2）ng/L]and vascular ET [（68.4±8.4）ng/L vs.（37.5±5.2）ng/L,P 〈0.01],and significant rise in left ventricular early diastolic peak filling velocity [E, （63.7±6.9）cm/s vs.（71.7±7.4）cm/s],left ventricular early/late diastolic peak filling velocity [E/A,（1.10± 0.13）vs.（1.34±0.16）],left ventricular ejection fraction [LVEF,（62.3±7.6）% vs.（66.4±7.1）%]and left ventricular end-diastolic diameter [LVEDd,（48.9±5.7）mm vs.（54.1±5.8）mm]in combined treatment group, P 〈0.05 or 〈0.01.Conclusion：Transcatheter closure combined drug intervention can reduce BNP and vascular ET concentrations,improve heart function,which possesses positive clinical application value.