前列地尔注射液对室间隔缺损介入治疗后血浆氨基末端脑利钠肽前体水平及心功能的影响
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Effects of Alprostadil on the Level of Plasma N-terminal Pro-brain Natriuretic Peptide and Heart Function After Interventional Therapy in Children with Ventricular Septal Defect
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    摘要:

    目的 观察先天性心脏病室间隔缺损(VSD)患儿介入封堵术后联合应用前列地尔注射液对术后血浆氨基末端脑利钠肽前体(NT-proBNP)水平及心功能的影响。方法 选择本院2011年1月至2013年1月住院行介入封堵治疗的VSD患儿120例,男51例,女69例,年龄5~8,平均6.1±2.3岁。随机分为前列地尔组60例,对照组60例,前列地尔组在封堵术后即刻注射前列地尔注射液连续7天,分别在术前、术后第3天、术后6个月采用双向侧流免疫法测定其血浆NT-proBNP水平,所有患儿在术前、术后第7天和术后6个月分别进行超声心动图检查,测定左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)、左心室收缩期末容量(LVESV)、左心室舒张期末容量(LVEDV)、左心室射血分数(LVEF),并比较两组临床特征、血浆NT-proBNP水平及心功能参数的变化。结果 两组患儿LVEDD、LVESD、LVEDV、LVESV在介入术后第7天及术后6个月均明显小于术前(P<0.05),且封堵术后6个月前列地尔组LVEDD、LVESD、LVEDV、LVESV较对照组减小更明显(P<0.05)。两组患儿术前血浆NT-proBNP水平无统计学差异(P>0.05);两组患儿血浆NT-proBNP水平术前与术后第3天、术后第3天与术后6个月比较差异均有统计学意义(P<0.01),且前列地尔组封堵术后3天、术后6个月较对照组下降更明显(P<0.01)。结论 VSD患儿介入封堵术联合前列地尔治疗可进一步降低血浆NT-proBNP水平并改善患儿心功能。

    Abstract:

    Aim To observe the level of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart function in children with ventricular septal defect (VSD) after interventional therapy combined alprostadil injection. Methods A total of 120 patients with VSD for cardiac catheter occlusion were enrolled in this study. All the patients were randomized to alprostadil group (n60) and control group (n60). Levels of plasma NT-proBNP were measured before and the third day and sixth month after cardiac catheterization, respectively. Before and the seventh day and sixth month after cardiac catheterization, the parameters of left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Results The parameters of LVEDD, LVESD, LVESV and LVEDV in the sixth month after catheterization were decreased significantly as compared to those before catheterization in the two groups (P<0.05, respectively), while those in the alprostadil group were more decreased as compared with the control group (P<0.05).There was no difference in plasma NT-proBNP level between control group and alprostadil group before catheterization (P>0.05). In the sixth month after catheterization, plasma NT-proBNP level decreased significantly as compared to that before catheterization in the two groups (P<0.01, respectively), while that in the alprostadil group were more decreased as compared with the control group (P<0.01). Conclusions Alprostadil injection combined interventional therapy can further reduce the level of plasma NT-proBNP and improve heart function in the children with VSD.

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刘 君,高 磊,刘 凌,谭慧莲,郑庆厚,王 震,张密林.前列地尔注射液对室间隔缺损介入治疗后血浆氨基末端脑利钠肽前体水平及心功能的影响[J].中国动脉硬化杂志,2014,22(8):839~841.

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  • 收稿日期:2013-12-31
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