介入封堵术对先天性心脏病患者血浆脑钠素水平影响.docVIP

介入封堵术对先天性心脏病患者血浆脑钠素水平影响 　 作者：李江津，田晓沂，马树人 【关键词】 脑钠素；先天性心脏病；介入封堵术；右心室功能 　　[摘要]目的 观察先天性心脏病患者在行介入封堵术后血浆脑钠素(BNP)水平的变化及其临床意义。方法 29例先天性心脏病患者，体重22~66 kg，年龄7~42岁。经Amplatz伞封堵后，于封堵术前1 d、术后3 d、术后6个月分别行超声心动图检查右心室功能，并采用ELISA法测定血浆BNP水平。结果 与术前相比,先天性心脏病患者行封堵术后3 d及6个月血浆BNP水平呈进行性下降（均Plt;0.01），术后3 d右心室舒张末期容积、射血分数均较术前下降,与术前比较有显著性差异(Plt;0.01)，而术后6个月右心室的舒张末期容积有进一步降低趋势，射血分数较术后3 d有进一步改善趋势,但无显著性差异(Pgt;0.05)。结论 先天性心脏病行封堵术后，观察患者血浆BNP水平变化有助于评估右心室功能的恢复情况。 　　[关键词]脑钠素；先天性心脏病；介入封堵术；右心室功能 　　Changes of plasma brain natriuretic peptide level in patients with congenital heart disease after transcatheter closure 　　(Department of Cardiology,Huai′an First Hospital Affiliated to Nanjing Medical University,Huai′an 223300,China)Abstract:Objective To observe the changes in plasma brain natriuretic peptide(BNP) level in patients with congenital heart disease after transcatheter closure.Methods Twentynine patients with congenital heart disease after transcatheter closure by Amplatz occluder were recruited into the study.Echocardiographic check up and plasma BNP level examinations by ELISA were done before and 3 days and six months after closure respectively.Results The concentration of plasma BNP decreased progressively in patients with congenital heart disease compared with that before closure.In the third day after closure the right ventricular enddiastolic volume (RVEDV),right ventricular ejection fraction(RVEF) were significantly decreased (all Plt;0.01).In the sixth month,a tendency of decrement of right ventricular enddiastolic volume and improvement of right ventricular ejection fraction were observed compared with those of the third day after closure,but it showed no significant difference(Pgt;0.05).Conclusion The plasma BNP level in patients with congenital heart disease after transcatheter closure decrease progressively.The changes in plasma BNP level in patients with congenital heart disease after transcatheter closure would contribute to evaluate the recovery of right ventricular function. 　　Key wor