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目的:探讨不同病因的小儿充血性心力衰竭血浆心钠素(PANP)的临床意义。方法:对住院的各种充血性心力衰竭患儿 25例,分为两组,Ⅰ组为先心(左向右分流型)并肺炎心衰13例;Ⅱ组为肺炎心衰12例。正常对照组20例。用放射免疫分析方法 进行测定PANP浓度。结果:各种不同病因心衰的PANP水平均显著高于对照组(P<0.01),先心肺炎心衰其值更高。本文发现 肺炎心衰组PANP水平明显低于先心肺炎心衰组,其原因考虑为第一没有基础心脏病;第二最近有学者提出婴儿重症肺炎不合并 心衰。结论:先心肺炎心衰的PANP水平明显增高,说明有基础心脏病并肺炎时更易合并心衰。因此,对有基础心脏病的患儿作 PANP监测更有意义。肺炎时测定PANP意义不大,重症肺炎PANP升高考虑为肺动脉高压所致,不一定合并心衰。
Objective: To investigate the clinical significance of plasma atrial natriuretic peptide (PANP) in children with congestive heart failure of different etiologies. Methods: Twenty-five children with congestive heart failure were divided into two groups. Group Ⅰ was congenital (left-to-right shunt) with pneumonia and heart failure in 13 cases. Group Ⅱ was pneumonia with heart failure in 12 cases. Normal control group of 20 cases. The PANP concentration was determined by radioimmunoassay. Results: The PANP levels of various etiologies were significantly higher than those of the control group (P <0.01). This paper found that patients with pneumonia, heart failure group PANP levels were significantly lower than those of heart failure group, the reason considered as the first without underlying heart disease; the second recent scholars have suggested that infants with severe pneumonia without heart failure. CONCLUSIONS: The level of PANP in patients with congenital heart failure and heart failure is significantly higher, indicating that it is more likely to be associated with heart failure in patients with underlying heart disease and pneumonia. Therefore, PANP monitoring of children with underlying heart disease is more meaningful. Pneumonia determination of PANP little meaning, severe pneumonia PANP increased due to pulmonary hypertension, may not necessarily complicated by heart failure.