先天性心脏病患儿围手术期肺动脉压力和B型脑钠肽的相关性研究

目的研究先天性心脏病患儿围手术期肺动脉压力和B型脑钠肽之间的关系。方法选择自2010年1月至2013年6月在我院住院的先天性心脏病患儿68例，入院后24小时内和术后1周分别测定BNP和采用心超测定肺动脉压力，然后根据入院时肺动脉压力分组，分为 PAP≤30 mmHg 组，30 mmHg＜PAP＜90 mmHg，PAP≥90 mmHg三组。结果在入选的先天性心脏病患儿中，术前PAP≤30 mmHg组BNP（186±11．2）pg/ml，明显低于30 mmHg＜PAP＜90 mmHg组（835±46．8）pg/ml，后者又明显低于PAP≥90 mmHg组（1104．5±69．3）pg/ml，（P＜0．01）。术后三组肺动脉压力均较术前明显下降，分别为（16．8±1．5）mmHg，（17．2±1．6）mmHg，（17．8±1．9）mmHg。术后三组BNP分别为（140±9．1）pg/ml，（145±10．3）pg/ml，（151±10．6）pg/ml。结论先天性心脏病患儿在手术矫正血液分流前，肺动脉压力和BNP密切相关，肺动脉压力越高，BNP水平也越高。术后随着血液动力学改善，肺动脉压力较术前迅速改善，BNP水平也明显下降。术后BNP水平高低与术前肺动脉压力无明显相关性。

The correlation study of perioperative pulmonary artery pressure and B-type natriuretic peptide in children with congenital heart disease

Objective To study the relationship between perioperative pulmonary artery pressure and B-type natriuretic peptide in children with congenital heart disease .Methods 68 cases those who suffered from congenital heart disease were selected from our hospital during January 2010 and June 2013,BNP and pulmonary artery pressure were measured within 24 hours after admission and 1 week after surgery , then they were divided into PAP ≤30mmHg group, 30mmHg 〈PAP 〈90mmHg group and PAP≥90 mmHg group according to pulmonary artery pressure measured at the time of admission .Results In selected children with congenital heart disease, preoperative concentration of BNP of PAP ≤30mmHg group was 186 ±11.2pg/ml, which was significantly lower than 30mmHg〈PAP〈90mmHg group （835 ±46.8pg/ml）, also significantly lower than the PAP≥90mmHg group （1104.5 ±69.3.8pg/ml）（P〈0.01）.Pulmonary artery pressure significantly decreased respectively compared with that of preoperative （ 16 ±1.5mmHg, 18 ±1.8mmHg, 20 ±2.1mmHg.BNP concentrations of the three groups were （130 ±9.1pg/ml, 145 ±10.3pg/ml, 161 ±10.3pg/ml） after operation. Conclusions Pulmonary artery pressure and BNP was positively related before surgical treatment , but there was no significant correlation between them postoperative .