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目的研究先天性心脏病(CHD)合并肺动脉高压(PH)患儿血清心肌型脂肪酸结合蛋白(H-FABP)的变化及其与肺动脉收缩压(PASP)的相关性,探讨H-FABP对于诊断CHD合并PH的临床意义。方法 2012年9月至2013年1月山西省儿童医院心外科及心内科CHD患儿66例,对全部患儿进行彩色超声心动图检查,明确CHD类型并测定PASP,根据彩超结果分为4组:无PH患儿16例,合并轻度PH患儿18例,合并中度PH患儿17例,合并重度PH患儿15例。同期门诊体检儿童20名为正常对照组。应用酶联免疫吸附法(ELISA)测定各组研究对象血清H-FABP浓度。结果 CHD各组患儿血清H-FABP高于正常对照组(P<0.05),CHD合并PH各组患儿血清H-FABP高于无PH组,且H-FABP随肺动脉压力程度增加而升高,与PASP成正相关(r=0.952,P<0.05)。结论 CHD患儿早期虽未形成肺动脉高压,但已存在一定心肌损害,血清H-FABP升高。当合并PH时,心肌损害明显加重,血清H-FABP明显升高,且随肺动脉压力程度的加重而升高,对于CHD合并PH患儿病情评估有一定指导意义。
Objective To investigate the changes of serum myocardial fatty acid binding protein (H-FABP) and pulmonary artery systolic blood pressure (PASP) in children with congenital heart disease (CHD) complicated with pulmonary hypertension (PH) and to explore the relationship between H-FABP and the diagnosis of CHD The clinical significance of PH combined. Methods From September 2012 to January 2013, 66 children with CHD in Department of Cardiology and Cardiology of Children’s Hospital of Shanxi Province were enrolled. Color echocardiography was performed on all children. CHD type was determined and PASP was determined. According to the results of color Doppler ultrasonography, the results were divided into 4 groups : 16 children without PH, 18 children with mild PH, 17 children with moderate PH, and 15 children with severe PH. Over the same period outpatient checkup 20 children as a normal control group. Serum H-FABP concentrations in each group were determined by enzyme-linked immunosorbent assay (ELISA). Results The serum levels of H-FABP in CHD group were higher than those in normal control group (P <0.05). The serum H-FABP in CHD group was higher than that in non-PH group and H-FABP was increased with the increase of pulmonary artery pressure , Positively correlated with PASP (r = 0.952, P <0.05). Conclusion Although there is no pulmonary hypertension in children with CHD at early stage, some myocardial damage exists and the serum H-FABP level increases. When combined with PH, myocardial damage significantly increased, serum H-FABP increased significantly, and increased with the degree of pulmonary artery pressure increased, for CHD PH patients with disease evaluation of a certain degree of guiding significance.