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目的探讨肺动脉高压(PAH)患儿血浆N端脑利钠肽前体(NT-proBNP)和右心室Tei(RVTei)指数和右心室面积变化分数(RVFAC)之间的相关性。方法对2007年1月至2012年11月韩国三星首尔医院就诊的38例次肺动脉高压患儿超声心动图和血清学检查资料进行回顾性分析。将肺动脉收缩压(PASP)>30mmHg～<70mmHg(1mmHg=0.133kPa)的16例次(轻中度组)与≥70mmHg的22例次(重度组)患儿进行分组分析。结果 (1)RVFAC、PASP和血浆NT-proBNP浓度在轻中度PAH组和重度PAH组之间差异有统计学意义(P<0.05)。RVTei指数在轻中度PAH组和重度PAH组之间差异无统计学意义(P>0.05)。(2)相关性分析:血浆NT-proBNP浓度与PASP呈正相关(r=0.544,P<0.05),与RVFAC呈负相关(r=-0.767,P<0.05)。RVFAC与PASP、血浆NT-proBNP浓度呈负相关(r=-0.711、-0.767,P<0.05)。RVTei与血浆NT-proBNP浓度、PASP、RVFAC均无相关性(r=-0.041、-0.048、0.016,P>0.05)。结论 PAH程度不同患儿血浆NT-proBNP浓度与RVFAC具有相关性。提示血浆NT-proBNP浓度与RVFAC可作为PAH患儿右心功能的评价指标。
Objective To investigate the correlation between NT-proBNP and RVTei and right ventricular area fraction (RVFAC) in children with pulmonary hypertension (PAH). Methods The data of echocardiography and serology of 38 patients with pulmonary hypertension treated at Seoul National Hospital of Samsung from January 2007 to November 2012 were analyzed retrospectively. Sixteen patients with mild to moderate pulmonary hypertension (PASP)> 30mmHg ~ <70mmHg (1mmHg = 0.133kPa) and 22 patients with severe disease ≥70mmHg were divided into two groups. Results (1) RVFAC, PASP and plasma NT-proBNP concentrations were significantly different between mild and moderate PAH group and severe PAH group (P <0.05). RVTei index in mild to moderate PAH group and severe PAH group, the difference was not statistically significant (P> 0.05). (2) Correlation analysis: Plasma NT-proBNP concentration was positively correlated with PASP (r = 0.544, P <0.05) and negatively correlated with RVFAC (r = -0.767, P <0.05). RVFAC and PASP, plasma NT-proBNP concentration was negatively correlated (r = -0.711, -0.767, P <0.05). RVTei had no correlation with plasma NT-proBNP concentration, PASP and RVFAC (r = -0.041, -0.048, 0.016, P> 0.05). Conclusion Plasma NT-proBNP concentrations in children with different PAH levels are correlated with RVFAC. Tip plasma NT-proBNP concentration and RVFAC can be used as PAH in children with right heart function evaluation index.