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目的探讨先天性心脏病(CHD)患儿血浆脑尿钠肽(BNP)水平与心脏功能的关系及其在心导管介入治疗前后的变化特点。方法依据纽约大学儿童心力衰竭指数(NYUPHFI)对先天性心脏病患儿心脏功能进行评定,并分为并发心力衰竭组(心衰组,n=18)及未并发心衰组(非心衰组,n=25);利用超声心动图检测两组的左室射血分数(LVEF);采用罗氏床旁快速定量诊断仪测定全血BNP含量。结果入院时及介入术后心衰组及非心衰组间患儿血浆BNP、NYUPHFI及LVEF均有显著性差异(P<0.05,P<0.01),两组在介入治疗之后血浆BNP均显著下降(P<0.01);患儿血浆BNP浓度与LVEF呈显著负相关(r=-0.53,P<0.01);血浆BNP浓度与NYUPHFI呈显著正相关(r=0.61,P<0.01)。心衰组的先心病患儿血浆BNP浓度与LVEF呈显著负相关(r=-0.62,P<0.01),且血浆BNP浓度与NYUPHFI呈正相关(r=0.78,P<0.01),但在非心衰组未见有统计学意义的相关性。结论先天性心脏病患儿血浆BNP与心脏功能密切相关,介入治疗后随着心脏功能的改善BNP浓度下降。
Objective To investigate the relationship between plasma brain natriuretic peptide (BNP) levels and cardiac function in children with congenital heart disease (CHD) and their changes before and after cardiac catheterization. Methods According to New York University Children’s Heart Failure Index (NYUPHFI), the cardiac function of children with congenital heart disease was evaluated and divided into two groups: heart failure group (n = 18) and non-heart failure group , n = 25). Left ventricular ejection fraction (LVEF) was measured by echocardiography. Whole blood BNP level was measured by Roche bedside rapid quantitative diagnostic apparatus. Results There were significant differences in plasma BNP, NYUPHFI and LVEF between admission and after PCI (P <0.05, P <0.01), and plasma BNP decreased significantly after intervention in both groups (P <0.01). There was a significant negative correlation between plasma BNP concentration and LVEF (r = -0.53, P <0.01). There was a significant positive correlation between plasma BNP concentration and NYUPHFI (r = 0.61, P <0.01). There was a significant negative correlation between plasma BNP concentration and LVEF in CHF group (r = -0.62, P <0.01), and plasma BNP concentration was positively correlated with NYUPHFI (r = 0.78, P <0.01) No significant correlation was found between the two groups. Conclusion The plasma BNP level in children with congenital heart disease is closely related to the cardiac function. The BNP level decreases with the improvement of cardiac function after interventional therapy.