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室间隔缺损封堵术前后血浆BNP、ANP的变化及意义(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第2期
页码:
207-209
栏目:
临床研究
出版日期:
2008-03-20

文章信息/Info

Title:
Significance of plasma BNP and ANP variations after transcatheter closure of ventricular septal defect
作者:
张倩; 宋治远; 柴虹; 张志辉; 仝识非; 刘建平; 冉擘力; 李永华
第三军医大学西南医院心内科，重庆 400038
Author(s):
ZHANG Qian;  SONG Zhiyuan;  CHAI Hong;  ZHANG Zhihui;  TONG Shifei;  LIU Jianping;  RAN Boli;  LI Yonghua
Department of Cardiology,Southwest Hospital,Third Military Medical University,Chongqing 400038,China
关键词:
室间隔缺损; 介入治疗;  脑钠尿肽;  心房钠尿肽
Keywords:
ventricular septal defect; transcatheter closure; brain natriuretic peptide; atrial natriuretic peptide
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 探讨室间隔缺损（VSD）封堵术对患者血浆脑钠尿肽（BNP）、心房钠尿肽（ANP）的影响及意义。方法 以在我院接受封堵术治疗的187例VSD患者为研究对象，按心脏超声测得的肺体循环血流量比值（Qp/Qs）分为A组(Qp/Qs＜1.5，98例)与B组(Qp/Qs≥1.5，89例)；分别于封堵术当日07∶00及封堵术后24 h、72 h各抽取静脉血5 ml，用酶联免疫吸附法检测血BNP浓度，用放射免疫法检测血清ANP浓度。结果 ①B组肺动脉压力较A组显著升高（P<0.05）。②术前B组血浆BNP浓度较A组及对照组显著升高（P<0.05）；术后24 h及72 h两组血浆BNP浓度均较术前显著升高(P<0.01)，而术后72 h虽较术后24 h有下降趋势，但无统计学差异。③术前两组患者血浆ANP浓度均较对照组显著升高（P<0.05），而术后72 h则较术前显著降低（P<0.05），其中A组已达正常对照组水平。结论 VSD患者血浆BNP及ANP浓度与肺循环血量多少及肺动脉压力呈正相关；术后早期血浆ANP浓度的变化特征，可作为VSD封堵术后远期疗效判断的一项重要指标。
Abstract:
AIM To evaluate the influence of transcatheter closure of ventricular septal defect (VSD) on the variation of plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP). METHODS One hundred and eightseven VSD cases who had undergone transcatheter closure treatment in our hospital were divided into group A (Qp/Qs<1.5, 98 cases) and group B (Qp/Qs≥1.5, 89 cases) according to the ratio of pulmonary blood flow and systemic flow blood (Qp/Qs) measured by echocardiogram. The concentration of ANP and BNP was detected with venous blood of patients 24 h and 72 h after transcatheter closure by enzyme linked immunosorbent assay and radioimmunity respectively. RESULTS ①The pulmonary arterial pressure of patients from group B was obviously higher than that of group A before transcatheter clusure treatment（P<0.05）. ②The concentration of plasma BNP of patients from group A was also higher than that of group A and control group before transcatheter closure treatment. 24 h and 72 h after transcatheter closure, the concentration of plasma BNP of both group A and B increased significantly (P<0.01) though a descend after 24h was observed, with no statistic variance between 24 h and 72 h. ③The concentration of plasma ANP of both groups was higher than that of the control（P<0.05）. 72 h after transcatheter closure treatment, the concentration level of plasma ANP dropped significantly（P<0.05） and that of group A fell to the level of the control group. CONCLUSION The concentration of plasma BNP and ANP is positively correlated to the pulmonary blood flow and pressure. The concentration variation of plasma ANP early after transcatheter closure treatment can be an important index of longterm efficacy of transcatheter closure of VSD.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2007-06-26.通讯作者：宋治远，教授，主要从事先心介入治疗研究Email:zysong@public.cta.cq.cn 作者简介：张倩，主治医师Email:zhangq931@126.com
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