超声右心功能指标及B型脑钠肽诊断小儿心脏病伴肺动脉高压的临床价值

Clinical value of ultrasound right heart function indexes and B-type natriuretic peptide in the diagnosis of pediatric heart disease with pulmonary hypertension

目的分析超声右心功能指标及B型脑钠肽诊断小儿心脏病伴肺动脉高压的临床价值。方法选取2016年12月至2018年12月我院收治的200例心脏病伴肺动脉高压患儿作为观察组,另选取同期200例健康体检儿童作为对照组。比较两组的心肌作功指数(Tei指数)、肺体循环血流量比(Qp/Qs)、右心室变化率(FAC)及B型脑钠肽水平。将观察组患儿根据病情严重程度分为轻度组、中度组及重度组,比较各组的右心功能指标及B型脑钠肽水平。结果观察组的Tei指数、Qp/Qs、B型脑钠肽水平均高于对照组,FAC低于对照组(P<0.05)。重度组的Tei指数、Qp/Qs、B型脑钠肽水平均高于轻度组及中度组,FAC低于轻度组及中度组(P<0.05);中度组的Tei指数、Qp/Qs、B型脑钠肽水平均高于轻度组,FAC低于轻度组(P<0.05)。Tei指数、Qp/Qs、FAC、B型脑钠肽对该病的检出率均在80%以上。结论超声右心功能指标及B型脑钠肽可为小儿心脏病伴肺动脉高压的诊断提供科学依据,且能判断病情严重程度。

Objective To analyze the clinical value of ultrasound right heart function indexes and B-type natriuretic peptide in the diagnosis of pediatric heart disease with pulmonary hypertension.Methods A total of 200 children with heart disease with pulmonary hypertension admitted in our hospital from December 2016 to December 2018 were selected as the observation group,and another 200 healthy children during the same period were selected as the control group.Cardiac work index(Tei index),pulmonary systemic blood flow ratio(Qp/Qs),right ventricular change rate(FAC)and B-type natriuretic peptide level were compared between the two groups.The children in the observation group were divided into mild group,moderate group and severe group according to severity of the disease,and the right heart function indexes and B-type natriuretic peptide level of each group were compared.Results The Tei index,Qp/Qs and B-typenatriuretic peptide level of the observation group were higher than those of the control group,and FAC was lower than that of the control group(P<0.05).The Tei index,Qp/Qs and B-type natriuretic peptide level of the severe group were higher than those of the mild group and the moderate group,and FAC was lower than that of the mild group and the moderate group(P<0.05);the Tei index,Qp/Qs and B-type natriuretic peptide level of the moderate group were higher than those of the mild group,and FAC of the moderate group was lower than that of the mild group(P<0.05).For this disease,the detection rates of Tei index,Qp/Qs,FAC,and B-type natriuretic peptide are all above 80%.Conclusion Ultrasound right heart function indexes and B-type natriuretic peptide can provide scientific basis for the diagnosis of pediatric heart disease with pulmonary hypertension,and can judge the severity of the disease.