Oz-Tuncer Gokcen, Olgunturk Rana, Pektas Ayhan, Cilsal Erman, Kula Serdar, Oguz Deniz A, Tunaoglu Sedef F, Pasaoglu Ozge T, Pasaoglu Hatice
1Department of Pediatric Neurology,Ankara University Medical Faculty Hospital,Ankara,Turkey.
2Department of Pediatric Cardiology,Medical Faculty Hospital,Gazi University,Ankara,Turkey.
Cardiol Young. 2017 Mar;27(2):255-260. doi: 10.1017/S1047951116000408.
The present study aims to identify the role of inflammatory markers such as C-reactive protein, interleukin-6, and fractalkine in CHD-associated pulmonary hypertension in children.
This is a prospective review of 37 children with CHD-related pulmonary hypertension, 21 children with congenital heart defects, and 22 healthy children.
Serum C-reactive protein and interleukin-6 levels were significantly higher in the children with CHD-related pulmonary hypertension (respectively, p=0.049 and 0.026). Serum C-reactive protein concentrations correlated negatively with ejection fraction (r=-0.609, p=0.001) and fractional shortening (r=-0.452, p=0.007) in the pulmonary hypertension group. Serum fractalkine concentrations correlated negatively with ejection fraction (r=-0.522, p=0.002) and fractional shortening (r=-0.395, p=0.021) in the children with pulmonary hypertension. Serum interleukin-6 concentrations also correlated negatively with Qs (r=-0.572, p=0.021), positively with Rs (r=0.774, p=0.001), and positively with pulmonary wedge pressure (r=0.796, p=0.006) in the pulmonary hypertension group. A cut-off value of 2.2 IU/L for C-reactive protein was able to predict pulmonary hypertension with 77.5% sensitivity and 77.5% specificity. When the cut-off point for interleukin-6 concentration was 57.5 pg/ml, pulmonary hypertension could be predicted with 80% sensitivity and 75% specificity.
Inflammation is associated with the pathophysiology of pulmonary hypertension. The inflammatory markers C-reactive protein and interleukin-6 may have a role in the clinical evaluation of paediatric pulmonary hypertension related to CHDs.
本研究旨在确定炎症标志物如C反应蛋白、白细胞介素-6和趋化因子在儿童冠心病相关肺动脉高压中的作用。
这是一项对37例冠心病相关肺动脉高压患儿、21例先天性心脏病患儿和22例健康儿童的前瞻性研究。
冠心病相关肺动脉高压患儿的血清C反应蛋白和白细胞介素-6水平显著更高（分别为p = 0.049和0.026）。在肺动脉高压组中，血清C反应蛋白浓度与射血分数（r = -0.609，p = 0.001）和缩短分数（r = -0.452，p = 0.007）呈负相关。在肺动脉高压患儿中，血清趋化因子浓度与射血分数（r = -0.522，p = 0.00）和缩短分数（r = -0.395，p = 0.021）呈负相关。在肺动脉高压组中，血清白细胞介素-6浓度也与Qs呈负相关（r = -0.572，p = 0.021），与Rs呈正相关（r = 0.774，p = 0.001），与肺楔压呈正相关（r = 0.796，p = ）。C反应蛋白的临界值为2.2 IU/L时，预测肺动脉高压的敏感性为77.5%，特异性为77.5%。当白细胞介素-6浓度的临界值为57.5 pg/ml时，预测肺动脉高压的敏感性为80%，特异性为75%。
炎症与肺动脉高压的病理生理学相关。炎症标志物C反应蛋白和白细胞介素-6可能在与冠心病相关的小儿肺动脉高压的临床评估中发挥作用。
