室间隔缺损患儿介入治疗前后血清脑钠肽含量变化观测

目的观察室间隔缺损患者介入封堵前后血清脑钠肽（brain natriuretic peptide,BNP）浓度变化规律及术前BNP浓度与肺动脉平均压（MPAP）的关系.方法按NYHA心功能标准分级取心功能Ⅰ级49例先天性心脏病膜周型室间隔缺损患儿测量肺动脉平均压（MPAP）,根据肺动脉高压的程度,将肺动脉高压分为正常、轻、中三级.其测量值分别为〈20mmHg、〉20mmHg、〉30mmHg.于术前、术后即刻、术后24h、术后7d测量血清BNP浓度,分析介入封堵前后BNP浓度变化以及术前BNP浓度与肺动脉平均压（MPAP）的关系.结果先天性心脏病室间隔缺损患儿介入封堵术后即刻BNP浓度急剧上升,24h浓度下降,7d恢复至术前水平.术前肺动脉高压与BNP浓度相关.结论术前血清BNP浓度反应肺动脉高压程度,术后早期BNP浓度升高,后期下降。

Changes of Serum Brain Natriuretic Peptide in Children with Ventricular Septal Defect before and after Transcatheter Closure

Objective To observe the changes of serum BNP in children with ventricular septal defect before and after transcatheter closure,and explore the relation betwen the BNP levels and the pulmonary artery presses（MPAP） before transcatheter closure.Methods We measured the MPAP of 49 children with membrane-type ventricular septal defect and I level heart function according to the NYHA heart function Functional Classification.According to the degree of high pressure,the pulmonary artery pressure of the children was divided into normal,light,and moderate three levels.Its observed value was〈20 mmHg,〉20 mmHg,and 〉30 mmHg,respectively.Before transcatheter closure,transcatheter closure instantly,24 hours and 7 days after transcatheter closure,the serum BNP levels were measured.The changes of serum BNP levels before and after transcatheter closure were analyzed,and the relation betwen the BNP levels and the pulmonary artery presses（MPAP） before transcatheter closure was also analyzed.Results After transcatheter closure of ventricular septal defect,the serum BNP levels rised instantly,droped 24 hour later,and 7 days later restored to the levels before therapy.The serum BNP levels was related to pulmonary artery high pressure before transcatheter closure.Conclusion Before transcatheter closure,the serum BNP levels reflect the degree of pulmonary artery high pressure,and after transcatheter closure,the BNP levels elevates in the early period,and drops in the later period.