Amplatzer封堵器封堵动脉导管未闭前后心脏内分泌改变的观察

A dynamic observation of cardiac endocrinology changes in the PDA patients treated by transcatheter closure of Amplatzer occluders.

目的 观察Amplatzer封堵器封堵动脉导管未闭 (PDA)前后心脏内分泌功能有何改变 ,从一个侧面来了解封堵器对心脏活动是否存在不良影响 ;从而探讨该堵闭方法的安全性。方法 2 7例PDA需应用Amplatzer封堵器封堵治疗患儿在封堵前、封堵后 1～ 2天和封堵后 4～ 6周分别进行血浆心钠素、心指数和钠排泄分数测定。结果 2 7例PDA患儿封堵前血浆心钠素明显高于正常对照组 (P <0 .0 5 ) ;封堵后 1～ 2天血浆心钠素又有增高且明显高于封堵前和正常对照组 (P <0 .0 5 )。心指数在封堵前明显低于对照组和封堵后 4～ 6周 (P <0 .0 5 )。钠排泄在封堵后 1～ 2天明显增加 (P <0 .0 5 )。血浆心钠素、心指数和钠排泄分数在封堵后 4～ 6周与对照组比较无显著差异 (P >0 .0 5 )。结论 该方法封堵PDA不会改变心脏内分泌活动 ,相反通过纠正异常通道 ,使心脏内分泌活动恢复正常。从一个侧面反映该堵闭方法是安全的。

Objective To observe cardiac endocrinology changes in the PDA patients treated by transcatheter closure of Amplatzer occluders and investigate the safety of transcatheter closure of Amplatzer occluders. Methods Twenty-seven PDA patients did the measurements of the plasma natriurtic polypetide, cardiac index and fraction excretion natrium in different phases of the treatment by using the transcatheter closure of Amplatzer occluders (before and 1-2 days and 4-6 weeks after closure).Results The pANP in 27 PDA patients before the transcatheter closure was significantly higher than the normal controls (P< 0.05 ). 1-2 days after the transcatheter closure, the pANP in the patients was elevated as compared with that before closure and in normal controls (P< 0.05 ). The CI before closure was obviously lower in the patients than in normal controls and that after 4-6 week closure (P< 0.05 ). The FENa % was markedly increased after 1-2 day closure (P< 0.05 ). pANP, IC and FENa % showed no significant difference in the patients after 4-6 week closure as compared with normal controls (P> 0.05 ).Conclusion After the PDA patients treated by transcatheter closure of Amplatzer occluders, the cardiac endocrinology is not changed. On the contrary, this operation can correct the abnormality of the heart so make the heart has a normal function, suggesting the transcatheter closure of Amplatzer occluder is safe.