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目的研究先心病患者外用静脉血心钠素、环核苷酸与肺血流动力参数关系及外科矫治术后的变化。方法经临床确诊的３２例先心病人，用放射免疫法同步测定血中ＡＮＰ及环核苷酸浓度。术前对２１例患儿行右心导管检查并监测其血流动力参数。结果左向右分流型先心病人，血浆ＡＮＰ、ｃＧＭＰ明显高于对照组，二者呈正相关；血浆ＡＮＰ、ｃ－ＧＭＰ与肺动脉压相关显著，而与右房、右室压无相关性。术后７～１８天血中ＡＮＰ、ｃＧＭＰ含量无明显下降。结论左向右分流的先心病人，心房扩张，血浆ＡＮＰ值升高；血浆ｃＧＭＰ浓度随ＡＮＰ的不同而变化，提示ｃＧＭＰ是ＡＮＰ的第二信使；手术前后血中ＡＮＰ、ｃＧＭＰ水平无明显差异，可能与肺动脉压及肺血管阻力尚未降至正常有关。
Objective To study the relationship of peripheral blood atrial natriuretic peptide, cyclic nucleotide and pulmonary hemodynamic parameters in patients with congenital heart disease and the changes after surgical treatment. Methods 32 cases of clinically diagnosed patients with congenital heart disease, simultaneous determination of plasma ANP and cyclic nucleotide concentration by radioimmunoassay. Twenty-one children underwent right heart catheterization and blood flow parameters were monitored before operation. Results Left-right shunt congenital heart disease patients, plasma ANP, cGMP was significantly higher than the control group, the two was positively correlated; plasma ANP, c-GMP significant correlation with pulmonary arterial pressure, and right atrial and right ventricular pressure was not related. After 7 to 18 days of blood levels of ANP, cGMP no significant decline. CONCLUSIONS: Patients with congenital heart disease with left-to-right shunting have atrial expansion and increased plasma ANP. Plasma cGMP concentration changes with ANP, suggesting that cGMP is the second messenger of ANP. There was no significant difference in ANP and cGMP levels before and after surgery, May be related to pulmonary artery pressure and pulmonary vascular resistance has not been reduced to normal.