Tei指数及脑钠肽评估先天性心脏病婴儿术前左心功能的研究

目的探讨检测血清脑钠肽浓度结合左心室Tei指数评估先天性心脏病婴儿术前左心功能的临床应用价值。方法选择先天性心脏病患儿60例为试验组,同期小儿外科住院患儿20例为对照组,将心功能分为四级,用多普勒超声心动图测量左心室Tei指数及左心室射血分数,采用酶联免疫吸附法(ELISA)检测血清BNP浓度。结果患儿血清BNP浓度、左心室Tei指数在心功能0级、Ⅰ级、Ⅱ级、Ⅲ级组呈逐渐增高趋势,左心室射血分数呈逐渐减低趋势,且方差分析显示各组间均数比较,差异有统计学意义(P0.01)。直线相关分析显示,血清BNP浓度与左心室Tei指数、心功能分级具有良好的正相关关系(r1=0.73,P0.01;r2=0.62,P0.01),与左心室射血分数具有负相关关系(r3=-0.48,P0.01);左心室Tei指数与心功能分级呈正相关关系(r4=0.57,P0.01),与左心室射血分数呈负相关关系(r5=-0.52,P0.01);左心室射血分数与心功能分级呈负相关关系(r=-0.56,P0.01)。结论 Tei指数及血清BNP浓度能够迅速、准确评估术前先天性心脏病婴儿心功能,具有临床推广应用价值。

Brain natriuretic peptide and Tei-index for assessing preoperative left heart function in infants with congenital heart diseases

Objectives To evaluate systolic and diastolic function of heart in infants with congenital heart diseases （CHD） by brain natriuretic peptide （BNP） in serum and Tel-index of left ventricle before operation. Methods Experiment group included 60 infants with CHD.Control group included 20 infants with pediatric surgery disease.Serum concentration of BNP was measured by enzyme linked immunosorbent assay（ELISA）. Tel-index and left ventricular ejection fraction （LVEF） were examined by Doppler echocardiography. Results Concentrations of serum BNP and Tei-index of left ventricle gradually increased while LVEF gradually decreased in cardiac functional grading 0, Ⅰ , Ⅱ , Ⅲ group. Analysis of variance indicated that there were statistical significances among the groups （P〈0.05）. Linear correlation analysis indicated that concentrations of serum BNP positively correlated with Tel-index of left ventricle and cardiac functional grading （r1=0.73,P〈0.01 ; r2=0.62,P〈0.01 ）, negatively correlated with LVEF （r3=-0.48,P〈0.01） ; Tei- index of left ventricle positively correlated with cardiac functional grading （r4=0.57, P〈0.01 ）, negatively correlated with LVEF（rs=-0.52,P〈0.01 ）; LVEF negatively correlated with cardiac functional grading（r=-0.56,P〈0.01）. The serum BNP and Tei-index were significantly increased with the severity of heart function. Serum BNP and Tel-index positively correlated with heart function and had a negative correlation with LVEF. Conclusions Concentration of serum BNP and Tel-index can quickly and accurately evaluate heart function of infants with CHD before operation.