Cheng Yao-Yao, An Jin-Dou, Feng Song, Ge Wei
Department of Pediatrics, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Mar;19(3):313-317. doi: 10.7499/j.issn.1008-8830.2017.03.012.
To examine the changes in serum chromogranin A (CgA) and urotensin II (U II) levels in children with chronic heart failure (CHF) and their clinical significance.
A total of 58 children with CHF, among whom 17 had endocardial fibroelastosis (EFE) and 41 had dilated cardiomyopathy (DCM), were selected as CHF group, and 20 healthy children were selected as control group. Serum levels of CgA and U II were measured using enzyme-linked immunosorbent assay, and the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) was determined by bi-directional lateral flow immunoassay. Ventricular remodeling indices were measured using echocardiography. The correlation between serum CgA and U II levels and ventricular remodeling was evaluated by Pearson correlation or Spearman's rank correlation analysis.
There were no significant differences in serum CgA and NT-proBNP levels between children with grade II heart function and the control group (P>0.05). However, the serum CgA and NT-proBNP levels gradually increased as the heart function grade increased, and were significantly higher in grade III and IV children compared to those in the control group (P<0.05). U II levels were lower in children with grade II, III, or IV heart function than those in the control group (P<0.05), and significantly decreased with the aggravation of CHF (P<0.05). There were no significant differences in CgA and U II levels between patients with EFE and DCM (P>0.05). Serum CgA concentration was positively correlated with left ventricular mass index (LVMI), NT-proBNP, and cardiac function classification (r=0.279, 0.649, and 0.778 respectively; P<0.05), but was negatively correlated with left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and U II (r=-0.369, -0.322, and -0.718 respectively; P<0.05). Serum U II concentration was negatively correlated with NT-proBNP and cardiac function classification (r=-0.472 and -0.591 respectively; P<0.05), but was not correlated with LVMI, LVEF, and LVFS (P>0.05).
CgA may play a role in ventricular remodeling in children with CHF. Serum CgA and U II may serve as a reference for the diagnosis and functional classification of heart failure.
探讨慢性心力衰竭（CHF）患儿血清嗜铬粒蛋白A（CgA）和尾加压素II（U II）水平的变化及其临床意义。
选取58例CHF患儿作为CHF组，其中17例患有心内膜弹力纤维增生症（EFE），41例患有扩张型心肌病（DCM），选取20例健康儿童作为对照组。采用酶联免疫吸附测定法检测血清CgA和U II水平，采用双向侧流免疫测定法测定N末端脑钠肽前体（NT-proBNP）水平。采用超声心动图测量心室重构指标。通过Pearson相关分析或Spearman等级相关分析评估血清CgA和U II水平与心室重构之间的相关性。
心功能II级患儿与对照组血清CgA和NT-proBNP水平比较，差异无统计学意义（P>0.05）。然而，随着心功能分级增加，血清CgA和NT-proBNP水平逐渐升高，心功能III级和IV级患儿显著高于对照组（P<0.05）。心功能II级、III级或IV级患儿U II水平低于对照组（P<0.05），且随CHF病情加重显著降低（P<0.05）。EFE和DCM患者CgA和U II水平比较，差异无统计学意义（P>0.05）。血清CgA浓度与左心室质量指数（LVMI）、NT-proBNP及心功能分级呈正相关（r分别为0.279、0.649和0.778；P<0.05），与左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）及U II呈负相关（r分别为-0.369、-0.322和-0.718；P<0.05）。血清U II浓度与NT-proBNP及心功能分级呈负相关（r分别为-0.472和-0.591；P<0.05），与LVMI、LVEF及LVFS无相关性（P>0.05）。
CgA可能在CHF患儿心室重构中起作用。血清CgA和U II可作为心力衰竭诊断及功能分级的参考指标。
