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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2010年第1期

页码:

72-74

栏目:

临床研究

出版日期:

2010-01-04

文章信息/Info

Title:

Changes of endocrine secretion and its relevance with ventricular remodeling after transcatheter closure of patent ductus arteriosus

作者:

付金国¹; 郭治彬²; 王梦洪²; 陈树平¹

1.沧州市中心医院心内科,河北 沧州 061001；2.南昌大学第一附属医院心内科,江西 南昌 075000

Author(s):

FU Jin-guo¹;  GUO Zhi-bin²;  WANG Meng-hong²;  CHEN Shu-ping¹

1.Department of Cardiology, Cangzhou Central Hospital, Cangzhou 061001, Hebei, China; 2.Department of Cardiology, First Affiliated Hospital, Nanchang University, Nanchang 330006, Jiangxi, China

关键词:

动脉导管未闭; 心房钠尿肽; 脑钠尿肽; 封堵器

Keywords:

natriuretic peptide;  patent ductus arteriosus;  occluder

分类号:

R541.1

DOI:

-

文献标识码:

A

摘要:

目的: 研究经皮动脉导管未闭（PDA）介入封堵术对血浆心房钠尿肽（ANP）、脑钠尿肽（BNP）、心室重构的影响。方法: PDA经导管封堵术的患者16例，年龄相当的健康人16名为对照组，采用放射免疫与酶联免疫法分别检测二组术前及术后10 min，2 d，3月血浆ANP和BNP的水平。应用超声心动图测定左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)和主动脉瓣血流速度峰值(Vp)等，并将PDA封堵术前后血浆ANP和BNP的变化与LVEDD和LVESD等指标的变化作相关性分析。结果: PDA患者术前血浆ANP和BNP水平较正常组显著升高(P<0.01)，术后10 min，2 d 患者血浆ANP和BNP水平较术前显著升高(P<0.01)，术后3月血浆ANP和BNP水平均恢复到正常范围。PDA封堵前左房内径，LVEDD，LVESD，LVFS，LVEF，Vp均较正常对照组明显增大(P<0.05),术后2 d均明显减小(P<0.05),术后3月恢复到正常范围内,PDA 封堵后右室舒张末期前后径(RVEDD)未见明显改变。PDA封堵术后血浆ANP和BNP水平的变化与LVEDD和LVEF的变化呈负相关。结论: 介入封堵治疗后PDA患者血浆ANP和BNP水平短期内均显著升高，术后3月恢复正常。短期内血浆ANP和BNP水平的变化与LVEDD和LVEF的变化呈负相关。

Abstract:

AIM: To observe the changes of plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in patients with patent ductus arteriosus (PDA) treated by transcatherter closure and to identify the correlation between changes of endocrine secretion and ventricular remodeling after transcatheter closure. METHODS: Sixteen patients with PDA underwent transcatheter closure using occluder. Plasma concentrations of ANP and BNP were measured before and after closure at 10 min, 2 days and 3 months, respectively. LVEDD, LVESD, LVEF and LVFS were measured echocardiographically before and after transcatheter closure at 2 days and 3 months, respectively. RESULTS: Plasma concentration of ANP and BNP of all patients before transcatheter closure was significantly higher than normal (P<0.01). Ten minutes and 2 days after transcatheter closure, plasma concentration of ANP and BNP was higher than before transcatheter closure and of the normal value (P<0.01). Before transcatheter closure, LAD LVEDD, LVESD, LVEF and LVFS were significant higher than normal (P<0.01). Two days after transcatheter closure, LVEDD, LVESD, LVEF and LVFS resulted lower than before transcatheter closure. Changes of ANP and BNP after closure of PDA were negatively correlated with LVEDD and LVEF. ANP and BNP, as well as LVEDD, LVESD, LVEF and LVFS, returned to normal 3 months after transcatheter closure. CONCLUSION: Plasma concentration of ANP and BNP increases significantly following transcatheter closure of PDA but returns to normal in 3 months. Changes of plasma concentration of ANP/BNP are negatively correlated with changes of LVEDD and LVEF after transcatheter closure.

参考文献/References

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备注/Memo

备注/Memo:

收稿日期：2008-7-31.基金项目：江西省卫生厅科技计划课题资助（20061050） 通讯作者：郭治彬，主任医师，主要从事心脏病介入的研究Email:gzbjx@126.com 作者简介：付金国，主治医师，硕士生Email:jinguofu1972@126.com

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更新日期/Last Update: 2010-01-05