不同类型心力衰竭患儿血浆胱抑素C水平及心室构型变化研究

Alterations in plasma cystatin C and ventricular configuration in children with different types of heart failure

目的研究不同类型心力衰竭患儿血浆胱抑素C(Cys-C)及N端脑钠肽前体(NT-pro-BNP)水平及心功能、心室构型的变化。方法选取2015年1月至2020年6月期间入院治疗的63例心力衰竭患儿纳入心力衰竭组,将心力衰竭组患儿进行心力衰竭评分,按左室射血分数(LVEF)值分组,以同期44名健康体检儿童纳入对照组,对比2组及心力衰竭组内血浆Cys-C、NT-pro-BNP水平,心功能指标:左室射血分数(LVEF)、左室短轴缩短率(LVFS),心室重构指标:左室质量指数(LVMI)、相对室壁厚度(RWT),分析血浆Cys-C及NT-pro-BNP、LVMI、RWT水平。结果心力衰竭组患儿血浆Cys-C、NT-pro-BNP、LVMI大于对照组患儿(P<0.05);心力衰竭组RWT小于对照组患儿。射血分数降低的心衰组、射血分数中间范围的心衰组血浆Cys-C、NT-pro-BNP、LVMI、心力衰竭评分均高于射血分数保留的心衰组患儿。结论血浆胱抑素C水平、NT-pro-BNP水平可为不同类型心力衰竭患儿心功能、心室重构评估提供参考。

Objective To investigate the alterations in plasma levels of cystatin C(Cys-C)and N-terminal pro-brain natriuretic peptide(NT-pro-BNP),heart function,and ventricular configuration in children with different types of heart failure.Methods Included were 63 children with heart failure admitted to our hospital between January 2015 and June 2020(heart failure group).The children in the heart failure group were rated for heart failure and stratified by left ventricular ejection fraction(LVEF).A contemporary cohort of 44 health checkup children were included as the control group.The plasma Cys-C and NT-pro-BNP levels were compared between the two groups and within the heart failure group.Indicators for heart function included the left ventricular ejection fraction(LVEF)and left ventricular short axis fractional shortening(LVFS);indicators of ventricular remodeling included the left ventricular mass index(LVMI)and relative ventricular wall thickness(RWT).The plasma levels of Cys-C and NT-pro-BNP in relation to LVMI and RWT were analyzed.Results The plasma levels of Cys-C and NT-pro-BNP and LVMI in children of the heart failure group were higher than those in the control group(P<0.05).The RWT was lower in the heart failure group than that in the control group.Plasma levels of Cys-C and NT-pro-BNP,LVMI,and rating of heart failure in heart failure children with reduced LVEF(HFrEF)or mid-range LVEF(HFmrEF)were higher than those with preserved LVEF(HFpEF).Conclusion Plasma levels of Cys-C and NT-pro-BNP can offer references for assessing cardiac function and ventricular remodeling in children with different types of heart failure.