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目的观察充血性心力衰竭(PCHF)患儿血浆脑利钠肽(BNP)变化的影响。方法 40例PCHF患儿随机分为常规组(n=20)及卡维地洛治疗组(n=20),治疗前后进行多普勒超声心动图检测;观察两组治疗前后血浆BNP水平、临床症状、心胸比例、心率变化、心功能改善。结果 PCHF患儿血浆BNP水平(785±622)ng/L明显高于常规组[(114±48)ng/L(P<0.01)],卡维地洛治疗组治疗后血浆BNP水平(167±65)ng/L低于常规值[(351±154)ng/L(P<0.05)],临床症状明显改善,患儿心胸比例降低,心率减慢,射血分数(EF)显著提高(P<0.01)。结论充血性心力衰竭患儿血浆BNP水平显著升高,与EF呈负相关;卡维地洛治疗后可降低血浆BNP水平,明显抑制PCHF患儿心室重塑,改善患儿心功能。
Objective To observe the changes of plasma brain natriuretic peptide (BNP) in children with congestive heart failure (PCHF). Methods Forty children with PCHF were randomly divided into routine treatment group (n = 20) and carvedilol treatment group (n = 20). Doppler echocardiography was performed before and after treatment. Plasma BNP level, Symptoms, cardiothoracic proportions, heart rate changes, improved cardiac function. Results Plasma BNP levels in PCHF children (785 ± 622) ng / L were significantly higher than those in the conventional group [(114 ± 48) ng / L, P <0.01] (351 ± 154) ng / L (P <0.05). The clinical symptoms were significantly improved. The proportion of cardiothoracic and thoracic echocardiography was decreased, the heart rate was slowed and the ejection fraction (EF) was significantly increased <0.01). Conclusions Plasma BNP levels are significantly increased in children with congestive heart failure and negatively correlated with EF. Carvedilol treatment can decrease plasma BNP level, significantly inhibit ventricular remodeling and improve cardiac function in children with PCHF.