动脉导管未闭患儿经导管封堵术前、后心率变异性、肾上腺髓质素及B型利钠肽的变化

[Heart rate variability, adrenomedullin and B-type natriuretic peptide before and after transcatheter closure in children with patent ductus arteriosus].

作者信息

Wu Rong-zhou, Rong Xing, Ren Yue, He Xu-xiang, Xiang Ru-lian

机构信息

Department of Pediatric Cardiovascular, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical College, Wenzhou 325000, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2010 Apr;38(4):334-6.

PMID:20654079

Abstract

OBJECTIVE

To observe the changes of heart rate variability (HRV), adrenomedullin (ADM) and B-type natriuretic peptide (BNP) before and after transcatheter closure in children with patent ductus arteriosus.

METHODS

HRV spectral values (TF, VLF, LF, HF, LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus (Group PDA, n = 55) before and 3(rd) day, 3(rd) month after transcatheter closure therapy, and in 60 normal children (Group C).

RESULTS

(1) Compared with Group C, the HRV spectral values (TF, VLF, HF) were significantly lower (all P < 0.01), LF/HF and the concentrations of plasma ADM, BNP were significantly higher in patients with PDA before transcatheter closure (all P < 0.01). (2) Compared with the values before transcatheter closure values, plasma ADM were significantly reduced at 3(rd) day and 3(rd) month after transcatheter closure (P < 0.01), the HRV spectral values (TF, VLF, HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3(rd) month after transcatheter closure (P < 0.01 or P < 0.05).

CONCLUSIONS

HRV and plasma ADM, BNP improved significantly post transcatheter closure in children with patent ductus arteriosus.

摘要

目的

观察动脉导管未闭患儿经导管封堵术前、后心率变异性（HRV）、肾上腺髓质素（ADM）及B型利钠肽（BNP）的变化。

方法

采用24小时动态心电图检测55例动脉导管未闭患儿（动脉导管未闭组，n = 55）及60例正常儿童（对照组）经导管封堵治疗前、封堵术后第3天、第3个月的HRV频谱值（总功率、极低频功率、低频功率、高频功率、低频/高频比值），并测定血浆ADM及BNP浓度。

结果

（1）与对照组相比，动脉导管未闭患儿封堵术前HRV频谱值（总功率、极低频功率、高频功率）显著降低（均P < 0.01），低频/高频比值及血浆ADM、BNP浓度显著升高（均P < 0.01）。（2）与封堵术前相比，封堵术后第3天和第3个月血浆ADM显著降低（P < 0.01），封堵术后第3个月HRV频谱值（总功率、极低频功率、高频功率）显著升高，低频/高频比值及血浆BNP显著降低（P < 0.01或P < 0.05）。