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先天性心脏病患者血清高敏C反应蛋白升高与缺氧及脑钠肽有关。

Increased serum high-sensitivity C-reactive protein is related to hypoxia and brain natriuretic peptide in congenital heart disease.

作者信息

Tomita Hideshi, Takamuro Motoki, Soda Wataru, Hatakeyama Kinya, Tsutsumi Hiroyuki

机构信息

Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan.

出版信息

Pediatr Int. 2008 Aug;50(4):436-40. doi: 10.1111/j.1442-200X.2008.02581.x.

Abstract

BACKGROUND

Studies of adults have shown a direct association between increased serum concentrations of high-sensitivity C-reactive protein (hs-CRP) and atherosclerotic cardiovascular disease, diabetes, and chronic heart failure. Some studies have documented elevated hs-CRP in obese children and adolescents, and in patients with a history of Kawasaki disease, but there are few data on its clinical significance in congenital heart disease.

METHODS

Measurements of hs-CRP, brain natriuretic peptide (BNP), hemoglobin, and percutaneous oxygen saturation (SpO2) were done in the following 70 patients: 18 controls; 11 with hypoxia (SpO2 </= 85% and BNP < 40 pg/mL); 31 with raised BNP (BNP >/= 40 pg/mL and SpO2 > 85%); and 10 patients with hypoxia-BNP (SpO2 </= 85% and BNP >/= 40 pg/mL). Correlations between hs-CRP, and age, body mass index (BMI), hemoglobin, SpO2, and BNP were analyzed using single and multiple regression analysis.

RESULTS

Hs-CRP in the hypoxia-BNP group was higher than in the other three groups, while in the hypoxia and the BNP groups it tended to be higher than in the controls. Although single regression analysis showed significant correlations between hs-CRP and, age, BNP, hemoglobin, and SpO2, multiple regression analysis showed that only BNP and SpO2 had a significant correlation with hs-CRP.

CONCLUSIONS

In preoperative or postoperative congenital heart disease, patients who had hypoxia or increased BNP had a higher hs-CRP level than controls. Serum concentration of hs-CRP significantly correlated with SpO2 and plasma BNP levels, but not with age or BMI.

摘要

背景

针对成年人的研究表明,血清高敏C反应蛋白(hs-CRP)浓度升高与动脉粥样硬化性心血管疾病、糖尿病及慢性心力衰竭之间存在直接关联。一些研究记录了肥胖儿童和青少年以及有川崎病病史患者的hs-CRP升高情况,但关于其在先天性心脏病中的临床意义的数据较少。

方法

对以下70例患者进行了hs-CRP、脑钠肽(BNP)、血红蛋白及经皮血氧饱和度(SpO2)的检测:18例对照;11例缺氧患者(SpO2≤85%且BNP<40 pg/mL);31例BNP升高患者(BNP≥40 pg/mL且SpO2>85%);以及10例缺氧-BNP患者(SpO2≤85%且BNP≥40 pg/mL)。采用单因素和多因素回归分析来分析hs-CRP与年龄、体重指数(BMI)、血红蛋白、SpO2及BNP之间的相关性。

结果

缺氧-BNP组的hs-CRP高于其他三组,而缺氧组和BNP组的hs-CRP往往高于对照组。虽然单因素回归分析显示hs-CRP与年龄、BNP、血红蛋白及SpO2之间存在显著相关性,但多因素回归分析显示只有BNP和SpO2与hs-CRP存在显著相关性。

结论

在先天性心脏病术前或术后,有缺氧或BNP升高的患者hs-CRP水平高于对照组。hs-CRP的血清浓度与SpO2及血浆BNP水平显著相关,但与年龄或BMI无关。

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