先天性心脏病术后血清脑利钠肽与PICCO监测心功能的相关性

目的:探讨先天性心脏病(先心病)患儿心脏术后脑利钠肽(BNP)与脉搏轮廓温度稀释连续心排量(PICCO)监测心功能指标相关性,研究术后BNP对预后的预测价值。方法:对50例先心病患儿心功能按纽约心脏学会(NYHA)分级分为A、B、C组,取同期腹部手术患儿20例为对照组。测定各组术后24h血清BNP含量,测定实验组术后24hcTnI水平,用PICCO监测实验组患儿术后24h心排指数(CI)、血管外肺水指数(ELWI),同时记录术后正性肌力药物评分、呼吸机辅助时间、是否出现室性心律失常。结果:先心病组患儿术后24hBNP水平均高于对照组,BNP水平与CI、呼吸机辅助时间、正性肌力药物评分有显著相关性。BNP水平与cTnI、ELWI、室性心律失常关系不确切。结论:血清BNP能准确评价先心病术后心功能水平,可以用于心脏手术预后的预测。

Relationship Between Brain Natriuretic Peptide Levels and Cardiac Function Monitored by Pulse Indicator Continuous Cardiac Output After Cardiac Surgery in Congenital Heart Disease Children

Objective:To investigate the relevance between brain natriuretic peptide(BNP) and cardiac function measurement with pulse indicator continuous cardiac output(PICCO) after cardiac surgery in congenital heart disease(CHD) children,and to investigate the prognostic value of postoperative BNP.Methods:Fifty infants of CHD who underwent cardiac operation were allocated into A,B,and C groups according to NYHA grading.A control group included 20 infants for abdominal surgery at the same period.The 24 h postoperative serum BNP level was measured in each group,while 24 h postoperative cardiac index(CI) and extravascular lung water index(ELWI) mornitored by PICCO,and Troponin I levels were measured in A,B,and C groups.The dose of catecholamines,postoperative mechanical ventilation time,and the presence of ventricular arrhythmia were recorded.Results:The BNP levels in CHD groups after 24 h of cardiac surgery were significantly higher than in control group.The BNP level was correlated with CI,mechanical ventilation time,and the dose of catecholamines.But cTnI,ELWI and ventricular arrhythmia had no defined relationship with BNP level.Conclusion:The postoperative BNP level can evaluate cardiac function of CHD,and it can be used to predict the postoperative outcomes.