Chung Hung-Tao, Chang Yu-Sheng, Liao Sui-Ling, Lai Shen-Hao
1 Department of Paediatrics, Linkou, Taiwan.
3 Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan.
J Int Med Res. 2017 Apr;45(2):493-503. doi: 10.1177/0300060516685659. Epub 2017 Jan 1.
Objective To investigate the influence of surgical correction on biomarkers of endothelial dysfunction in children with congenital heart disease and to evaluate anthropometric data. Methods Children with pulmonary hypertension (PH) or Tetralogy of Fallot (TOF) who were scheduled for corrective surgery were enrolled in this prospective study. Age-matched healthy children were included as controls. Demographic, haemodynamic and cardiac ultrasonography data were collected. Blood samples were taken pre-surgery, 24-48 hours post-surgery and again 3-6 months later. Several biomarkers (protein C, soluble platelet selectin [CD62P], soluble endothelium selectin [CD62E], soluble leukocyte selectin [CD62L], plasma von Willebrand Factor [vWF] atrial natriuretic peptide [ANP], brain natriuretic peptide[(BNP] and insulin-like growth factor-1 [IGF-1]) were measured. Results Sixty-three children (32 with PH, 15 with TOF, and 16 controls) were enrolled. No significant differences between the PH and TOF groups were observed in the expression of biomarkers pre- and post-surgery. IGF-1 levels were closely related to anthropometric data, particularly those children with PH. Expression of IGF-1 and weight/height normalized after corrective surgery. Conclusions No significant endothelial dysfunction was observed in children with PH or TOF before or after corrective surgery. Significant retardation of growth, particularly weight, was found before surgery and may be related to IGF-1 suppression.
目的 探讨手术矫正对先天性心脏病患儿内皮功能障碍生物标志物的影响，并评估人体测量数据。方法 本前瞻性研究纳入计划接受矫正手术的肺动脉高压（PH）或法洛四联症（TOF）患儿。年龄匹配的健康儿童作为对照。收集人口统计学、血流动力学和心脏超声数据。在术前、术后24 - 48小时及3 - 6个月后采集血样。检测几种生物标志物（蛋白C、可溶性血小板选择素[CD62P]、可溶性内皮细胞选择素[CD62E]、可溶性白细胞选择素[CD62L]、血浆血管性血友病因子[vWF]、心房利钠肽[ANP]、脑利钠肽[BNP]和胰岛素样生长因子-1[IGF-1]）。结果 共纳入63例儿童（32例PH患儿、15例TOF患儿和16例对照）。术前和术后，PH组和TOF组生物标志物表达无显著差异。IGF-1水平与人体测量数据密切相关，尤其是PH患儿。矫正手术后IGF-1表达及体重/身高恢复正常。结论 在矫正手术前后，PH或TOF患儿均未观察到明显的内皮功能障碍。术前发现显著的生长发育迟缓，尤其是体重方面，可能与IGF-1抑制有关。
