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目的:探讨先天性心脏病(先心病)患儿心脏术后脑利钠肽(BNP)与脉搏轮廓温度稀释连续心排量(PICCO)监测心功能指标相关性,研究术后BNP对预后的预测价值。方法:对50例先心病患儿心功能按纽约心脏学会(NYHA)分级分为A、B、C组,取同期腹部手术患儿20例为对照组。测定各组术后24h血清BNP含量,测定实验组术后24hcTnI水平,用PICCO监测实验组患儿术后24h心排指数(CI)、血管外肺水指数(ELWI),同时记录术后正性肌力药物评分、呼吸机辅助时间、是否出现室性心律失常。结果:先心病组患儿术后24hBNP水平均高于对照组,BNP水平与CI、呼吸机辅助时间、正性肌力药物评分有显著相关性。BNP水平与cTnI、ELWI、室性心律失常关系不确切。结论:血清BNP能准确评价先心病术后心功能水平,可以用于心脏手术预后的预测。
Objective: To investigate the relationship between BNP and PICCO in patients with congenital heart disease (CHD) after cardiopulmonary bypass and to predict the prognosis of postoperative BNP value. Methods: Fifty patients with congenital heart disease were divided into groups A, B and C according to New York Heart Association (NYHA). Twenty children undergoing abdominal surgery during the same period were selected as the control group. The serum levels of BNP in each group were measured 24h after operation. The 24hcTnI level in the experimental group was determined. The PICC, CI, and ELWI in the experimental group were detected by PICCO. The positive Muscle Drug Score, Ventilator Assisted Time, Ventricular Arrhythmia. Results: The levels of 24hBNP in children with CHD after operation were significantly higher than those in control group. There was a significant correlation between BNP level and CI, ventilator support time and inosotics scores. The relationship between BNP levels and cTnI, ELWI, ventricular arrhythmia is not exact. Conclusion: Serum BNP can accurately evaluate the level of cardiac function in patients with congenital heart disease, which can be used to predict the prognosis of cardiac surgery.