Amplatzer封堵器治疗PDA前后PET、ANP及CI动态变化的临床研究

The Clinical Research of a Dynamic Observation of Plasma Endothelin and Atrial Natriuetic Polypeptid and Cardiac Index Changes in the PDA Patients Treated by Transcatheter Closure of Amplatzer Occluders

目的:探讨应用Amplatzer封堵器治疗动脉导管未闭(patent ductus arteriosus,PDA)前后血浆内皮素(plasma endothelin,PET)、心钠素(atrial natriuetic polypeptid,ANP)及心指数(cardiac index,CI)的动态变化,研究封堵器对PDA患儿心脏活动的影响和该方法的安全性。方法:应用Amplatzer封堵器治疗27例PDA患儿,分别检测封堵前、后1-2天和封堵后4-6周患儿体内PET、ANP及CI水平。结果:27例PDA患儿封堵前PET、ANP明显高于正常对照组;封堵1-2天后PET、ANP略有增高,与封堵前、对照组相比差异有显著性(P<0.05)。CI在封堵前明显低于正常对照组(P<0.05);PET、ANP及CI在封堵4-6周后与对照组比较无差别(P>0.05)。结论:Amplatzer封堵器封堵PDA后,PET、ANP可明显高于封堵前和正常对照组,但很快从封堵前的异常恢复到正常儿童水平;间接反映该堵闭方法的安全性。

Objective: To observe plasma endothelin (PET) and plasma atrial nalriuelic polypeptid (PANP) and cardiac index(CI) changes in the patients with patent ductus arteriosus(PDA) treated by transcatheter closure of Amplatzer occluders and understanding the safety. Methods: 27 patients with PDA were measured the PET and PANP and CI in different phases of the treatment by using the transcatheter closure of Amplatzer occluders (before, post 1 -2 days and 4-6 weeks). Results: The PET and PANP of all the cases before the transcatheter closure were significant higher than the normal (P<0.05); After the transcatheler closure 1-2 days the patients' PET and PANP got even more higher than before transcatheter closure and the normal (P<0.05). Meanwhile their CI in the two phases was significantly lower than normal. All the PANP、PET and CI went to normal after transcatheter closure 4-6 weeks(P>0.05). Conclusions: After the patients with PDA treated by transcatheter closure of Amplatzer occluders, the PANP and PET once reached a higher level but went to normal soon. It suggests that the transcatheter closure of Amplatzer occluder method is safety.