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慢性心衰患儿血浆心型脂肪酸结合蛋白和脑利钠肽水平改变

Changes of the serum heart-type fatty acid-binding protein and brain natriuretic peptide in chronic pediatric heart failure

摘要:

目的 观察慢性充血性心力衰竭(chronic heart failure,CHF)患儿血浆心型脂肪酸结合蛋白(heart-type fatty acid-binding protein,h-FABP)、脑利钠肽(brain natriurettic peptitie,BNP)水平改变,探讨二者在慢性心力衰竭患儿诊断中的临床应用价值.方法 选择50例CHF患儿作为观察组,同期选择30例健康体检儿童作为对照组.血浆h-FABP、BNP浓度测定采用酶联免疫吸附法(ELISA),并以心脏超声心动图测量左室收缩末期内径(LVESD)、舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)及心脏指数(CI).结果 CHF患儿血浆h-FABP、BNP浓度均明显高于健康对照组[(22.68±4.18) ng/mL和(6.31±1.72) ng/mL,(565.52±179.64) pg/mL和(31.22±9.83) pg/mL,均P<0.01)],且心衰程度越重,h-FABP、BNP浓度升高越明显(均P<0.01);EFE、DCM两组h-FABP、BNP水平均高于对照组(均P<0.01),而两组间h-FABP、BNP水平比较无统计学意义(均P>0.05);CHF患儿心功能明显降低,轻、中、重度心衰患儿LVEDD、LVESD、LVEF、LVSF、CI明显不同,心衰程度越重,心功能越差,两两比较差异具有统计学意义(均P<0.01);CHF患儿h-FABP与BNP血浆水平呈正相关(r =0.782,P<0.01);h-FABP血浆水平与心功能参数LVEDD、LVESD值呈正相关(分别r=0.626,0.662,均P<0.01),与LVEF、LVFS、CI值呈负相关(分别r=-0.652,-0.636,-0.709,均P<0.01);BNP血浆水平与心功能参数LVEDD、LVESD值呈正相关(分别r=0.733,0.689,均P<0.01),与LVEF、LVFS、CI值呈负相关(分别r=-0.745,-0.612,-0.791,均P<0.01).结论 血浆h-FABP、BNP水平均可作为小儿慢性心衰的生物学标志物,两者具有高度相关性.

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abstracts:

Objective To observe the changes of serum heart-type fatty acid-binding protein (h-FABP) and brain natriuretic peptide (BNP) for assessing the clinical values in children with chronic heart failure (CHF).Methods A total of 50 patients with CHF,including 22 endocardial fibroelastosis (EFE) cases and 28 dilated cardiomyopathy (DCM) cases,were enrolled.Thirty healthy children were enrolled as controls.The concentrations of serum h-FABP and BNP were measured by enzyme-linked immunosorbent assay (ELISA),and the left ventricular end-systolic diameter (LVESD),left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS),and cardiac index (CI) were measured by echocardiography.Results The concentrations of serum h-FABP and BNP in patients with CHF were significantly higher than those in control group (22.68 ±4.18 ng/mL vs.6.31 ± 1.72 ng/mL;565.52±179.64 pg/mLvs.31.22±9.83 pg/mL,all,P < 0.01),and h-FABP and BNP were positively correlated with the degree of heart failure (all,P <0.01),and they were both higher in group EFE and DCM than those in control group (all,P<0.01),but there was no statistically significant difference between the two groups (P > 0.05).The h-FABP concentration in CHF patients was positively correlated with BNP ((r =0.782,P <0.01).The h-FABP concentration in CHF patients was positively correlated with LVESD,LVEDD (r =0.626,O.662,respectively;all,P<0.01),and negatively correlated with LVEF,LVFS,and CI (r =-0.652,-0.636,-0.709,respectively;all,P < 0.01).The BNP concentration was also positively correlated with LVESD,LVEDD (r =0.733,0.689,respectively;all,P <0.01),and negatively correlated with LVEF,LVFS,and CI (r=-0.745,-0.612,-0.791,respectively;all,P<0.01).Conclusions Serum concentrations of h-FABP and BNP can be used as biomarkers to evaluate the severity of chronic heart failure.

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