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目的:探讨血浆脑钠肽(BNP)及Tei指数在左向右分流型先天性心脏病(CHD)患儿中的变化及其对心功能评价的价值。方法:44例左向右分流型CHD患儿按心室容量负荷分为左心型组及右心型组,对照组20例。应用ELISA方法测定血浆BNP浓度;超声心动图测量左室舒张末期内径(LVEDD)、右室舒张末期内径(RVEDD)、肺循环血流量/体循环血流量(Qp/Qs)、左室射血分数(LVEF)及左室Tei指数,进行比较;22例CHD患儿接受手术治疗,手术前后进行比较。结果:①与对照组比较,左心型和右心型CHD组血浆BNP浓度均显著增高(P<0.001),左室Tei指数亦增大(P<0.05);②左心型和右心型CHD组血浆BNP浓度分别与LVEDD和RVEDD、Qp/Qs、左室Tei指数呈正相关;③手术后CHD患儿血浆BNP浓度和左室Tei指数均低于术前(P<0.01)。结论:血浆BNP水平及Tei指数是评价左向右分流型CHD患儿心功能的有效、敏感指标,可为临床诊治工作和疗效判断提供参考。
Objective: To investigate the changes of plasma brain natriuretic peptide (BNP) and Tei index in children with left-to-right shunt congenital heart disease (CHD) and their clinical value. Methods: Forty-four children with left-to-right shunt CHD were divided into left-heart-type group and right-heart-type group according to ventricular volume load. The control group included 20 patients. Plasma BNP levels were measured by ELISA. Left ventricular end-diastolic diameter (LVEDD), right ventricular end-diastolic dimension (RVEDD), Qp / Qs and left ventricular ejection fraction ) And left ventricular Tei index, compared; 22 cases of children with CHD underwent surgery, compared before and after surgery. Results: ①Compared with the control group, plasma BNP concentrations in both left and right CHD groups were significantly increased (P <0.001) and Tei index in left ventricle was also increased (P <0.05); ② Left ventricular and right ventricular Plasma BNP levels in patients with CHD were positively correlated with LVEDD, RVEDD, Qp / Qs and Tei index of left ventricle respectively. ③ Plasma BNP concentration and Tei index of left ventricle in children with CHD after operation were lower than those before operation (P <0.01). Conclusion: Plasma BNP level and Tei index are effective and sensitive indexes for evaluating cardiac function in CHD children with left-sided right shunt, which may provide reference for clinical diagnosis and treatment.